NPIMap

Individual provider Active NPI

Tayo E Haiyede, DMSC, PA-C.

  • Physician Assistant
  • Summerville, SC
National Provider Identifier
1962586354
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1765 Issued in SC
Practice address
5500 Front St Ste 240
Summerville, SC 29486-8140
Phone
(843) 572-7727
NPI assigned
Oct 24, 2006
Last updated
Aug 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 011082 NY
Physician Assistant 363A00000X 1765 SC Primary

Addresses

Primary practice location

5500 Front St Ste 240
Summerville, SC 29486-8140

Mailing address

5500 Front St Ste 240
Summerville, SC 29486-8140
Phone (854) 220-9995

Other identifiers 1

IdentifierTypeStateIssuer
1408PAMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120409000357 SC Practitioner - Physician Assistant 7214036334 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1401 Main St
Bonneau, SC 29431-5013
Phone (843) 695-6071

2500 Elms Ctr Rd
N Charleston, SC 29406-9844
Phone (843) 695-6071

2550 Elms Ctr Rd
North Charleston, SC 29406-9844
Phone (843) 695-6071

3495 Iron Horse Rd
Ladson, SC 29456-4319
Phone (843) 695-6071

5500 Front St
Suite 240
Summerville, SC 29486-7735
Phone (843) 572-7727

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011082NYMDPhysical Therapy Assistant
1765SCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Primary Care Physicians, LLC CurrentSince Sep 11, 2023 Accepting new patients
Palmetto Primary Care Physicians, LLC CurrentSince Sep 11, 2023 Accepting new patients
Lich Faculty Practice Physician Assistant Past Accepting new patients
Nason Medical Center V, LLC Past Accepting new patients
Nason Medical Center IV, LLC Past Accepting new patients
Long Island College Hospital Physician Assistant Past Accepting new patients
Palmetto Primary Care Physicians, LLC Past Accepting new patients

Locations

1401 Main St
Bonneau, SC 29431
Phone (843) 825-3404

2500 Elms Center Rd
North Charleston, SC 29406
Phone (763) 348-2075

2550 Elms Center Rd
North Charleston, SC 29406
Phone (843) 302-8840

5500 Front St
Ste 240
Summerville, SC 29486
Phone (854) 220-9995

Interoperability endpoints

  • Direct secure messaging: tayo.haiyede@ppcp1.eclinicaldirectplus.com

Organizations & group practices 12

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 4

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1962586354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 FRONT ST STE 240",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294868140",
            "telephone_number": "854-220-9995",
            "fax_number": "843-569-5899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 FRONT ST STE 240",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294868140",
            "telephone_number": "843-572-7727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIYEDE",
        "first_name": "TAYO",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "DMSC, PA-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011082",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "1765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1408PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.