DR. HALEY MARIE MCKISSACK MD
NPI 1275152019
Orthopaedic Surgery - Sports Medicine in Charlotte, NC
About Dr. Haley Marie Mckissack Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. HALEY MARIE MCKISSACK MD (NPI 1275152019) is an individual sports medicine provider in Charlotte, North Carolina, licensed in North Carolina (DR.0074792) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS and is a graduate of Florida International Univ, College Of Medicine (2020).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Haley Marie Mckissack Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Haley Mckissack reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Colorado Springs, CO 80920
- Reassigned Medicare billing, Colorado enrollment
- 4,283 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CHARLOTTE, NC 28262
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Haley Mckissack's NPI number?
The NPI number for Haley Mckissack is 1275152019. It was assigned to this individual provider in the NPPES registry on April 12, 2020.
Where is Haley Mckissack located?
Haley Mckissack practices at 1824 E Arbors Dr, Charlotte, NC 28262. The listed phone number is (704) 863-4878.
What is Haley Mckissack's specialty?
The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.
Is Haley Mckissack enrolled in Medicare?
Yes. Haley Mckissack is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Haley Mckissack's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Haley Mckissack reassigns Medicare benefits to University Physicians Incorporated (Colorado Springs, CO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Haley Mckissack's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Haley Mckissack was last updated on August 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Haley Marie Mckissack, MD · NPI 1275152019
Sports Medicine physician in Charlotte, North Carolina. Individual provider, active in the CMS NPPES registry since April 12, 2020.
## Identity
- **NPI:** 1275152019 (Entity type: Individual)
- **Enumerated:** April 12, 2020
- **Primary specialty:** Orthopaedic Surgery - Sports Medicine · taxonomy 207XX0005X
- **State license:** DR.0074792 (North Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 1824 E ARBORS DR, Charlotte, NC 28262-2692
- **Phone:** (704) 863-4878
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** University Physicians Incorporated (NPI 1912366022, Colorado Springs, CO), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Florida International Univ, College Of Medicine, class of 2020
## Record status
- **NPPES last updated:** August 10, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1275152019) · Data from the CMS NPPES public registry.