Justin Michael Kolesar, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-12977 Issued in NC

Practice address

1585 Forney Creek Pkwy
Ste 2100
Denver, NC 28037-9514

Phone

(704) 489-0365

NPI assigned

Jun 9, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
• Atrium Health Lincoln Hospital, Lincolnton, NC, CCN 340145

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkolesar818657@carolinashealthcaresystem.direct-ci.com

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

• Carolinas Physicians Network Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Charlotte, NC
  • NPI 1477878890
  Medicare reassignment Care Compare group
• Carolinas Physicians Network Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1437038544
  NPD
• Carolinas Physicians Network Inc

  • Family Medicine Physician
  • Gastonia, NC
  • NPI 1851555734
  NPD

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

• Atrium Health Hospitals Inc

  • General Acute Care Hospital
  • Lincolnton, NC
  • NPI 1730055054
  Care Compare affiliation
• Carolinas Medical Center

  • Psychiatric Hospital Unit
  • Charlotte, NC
  • NPI 1053358945
  Care Compare affiliation
• Carolinas Medical Center

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1295789907
  Care Compare affiliation
• Carolinas Medical Center

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1376985135
  Care Compare affiliation
• Carolinas Medical Center

  • Children's Rehabilitation Hospital
  • Charlotte, NC
  • NPI 1699829887
  Care Compare affiliation
• Carolinas Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
  • NPI 1720029705

  Hospital

  Care Compare affiliation
• Carolinas Medical Center

  • Clinical Medical Laboratory
  • Charlotte, NC
  • NPI 1811005150

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1972232213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 FORNEY CREEK PKWY",
            "address_2": "STE 2100",
            "city": "DENVER",
            "state": "NC",
            "postal_code": "280379514",
            "telephone_number": "704-489-0365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLESAR",
        "first_name": "JUSTIN",
        "middle_name": "MICHAEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-09",
        "last_updated": "2024-07-15",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkolesar818657@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1585 Forney Creek Pkwy",
            "address_2": "Ste 2100",
            "city": "Denver",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280379514",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• K. Jasinski, D.M.D., P.C.
• Darren Steven Kalkan, DC
• Emma Kelley
• Amie Elizabeth Kirkby, DPT
• Karen Patricia Kleiner
• Maryrose Kopchinsky, RN, IBCLC
• Karen Marie Koutsky
• Keira Rochelle Kuhar
• Brooke Lachance, LCMHC, NCC
• Lakeshore Pediatric Center, P.a.

• Physician Assistant in Denver, NC
• Providers in Denver, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.