Individual provider Active NPI

Kelsey E Graziose

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1790679785
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2827 Lyndhurst Ave Ste 203
Winston Salem, NC 27103-4145
Phone
(336) 794-8624
Fax
(336) 231-8845
NPI assigned
Jun 5, 2025
Last updated
Oct 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2827 Lyndhurst Ave Ste 203
Winston Salem, NC 27103-4145

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 794-8624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251204001457 NC Practitioner - Physician Assistant 5395238638 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1226 Eastchester Dr
Suite 100
High Point, NC 27265-3116
Phone (336) 481-8540

125 Queens Rd
Charlotte, NC 28204-3278
Phone (704) 316-1220

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Sep 13, 2025 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Sep 13, 2025 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 4, 2026 Accepting new patients
Novant Medical Group, Inc. Past Accepting new patients

Locations

125 Baldwin Ave
Ste 200
Charlotte, NC 28204
Phone (704) 384-5043

125 Queens Rd
Charlotte, NC 28204
Phone (704) 384-5043

1226 Eastchester Dr
#100
High Point, NC 27265
Phone (336) 481-8540

1710 Kernersville Medical Pkwy
Ste 210
Kernersville, NC 27284
Phone (336) 564-4065

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

2827 Lyndhurst Ave
Ste 203
Winston Salem, NC 27103
Phone (336) 768-9510

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1749081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1790679785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-794-8624",
            "fax_number": "336-231-8845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2827 LYNDHURST AVE STE 203",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034145",
            "telephone_number": "336-794-8624",
            "fax_number": "336-231-8845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAZIOSE",
        "first_name": "KELSEY",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-05",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.