Individual provider Active NPI

Leslie Lynn Dicarlo-Hack, PA-C

  • Medical Physician Assistant
  • Columbia, MD
National Provider Identifier
1790696540
Registry record updated Sep 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C0000074 Issued in MD
Practice address
8908 Skyrock CT
Columbia, MD 21046-1418
Phone
(410) 913-0135
Fax
(410) 913-0135
NPI assigned
Sep 12, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0000074 MD Primary

Addresses

Primary practice location

8908 Skyrock CT
Columbia, MD 21046-1418

Mailing address

8908 Skyrock CT
Columbia, MD 21046-1418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789171200000",
    "number": "1790696540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8908 SKYROCK CT",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8908 SKYROCK CT",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461418",
            "telephone_number": "410-913-0135",
            "fax_number": "410-913-0135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICARLO-HACK",
        "first_name": "LESLIE",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-12",
        "last_updated": "2026-09-12",
        "certification_date": "2026-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0000074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.