Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Michael R. Staversky, PA-C

Individual provider Physician Assistant · NPI 1093317646

Michael R. Staversky, PA-C is a Physician Assistant in Ladson, South Carolina. Qualified in 2020, 6 years ago. Practices with Palmetto Primary Care Physicians LLC, a 148-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
6
Licensed in
SC
In the registry since
2020
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3495 Iron Horse Rd
Ladson, SC 29456-4319
Phone: (843) 793-5970
Fax: (843) 419-5391
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1722 Tranquility Blvd, Lancaster, SC 29720-0376 — (585) 329-1607

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 3892 (SC)

Record details

NPI number1093317646
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 9, 2020
Last updated in NPPESApril 26, 2024
Certification dateApril 26, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Palmetto Primary Care Physicians Llc — 148 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Ladson