NPIMap

Individual provider Active NPI

Sydney Elyse Kirk, PA-C

  • Physician Assistant
  • Charleston, SC
National Provider Identifier
1114780467
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
96 Jonathan Lucas St
Charleston, SC 29425-8900
Phone
(864) 792-7700
NPI assigned
Jan 31, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

96 Jonathan Lucas St
Charleston, SC 29425-8900

Mailing address

96 Jonathan Lucas St
Charleston, SC 29425-8900
Phone (864) 792-7700

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
I20241112001394 SC Practitioner - Physician Assistant 8921532078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1106 Chuck Dawley Blvd
Mount Pleasant, SC 29464-4183
Phone (843) 792-1414

1122 Chuck Dawley Blvd
Mt Pleasant, SC 29464-4183
Phone (843) 792-6200

1600 Midtown Ave
Mount Pleasant, SC 29464-3771
Phone (843) 792-1414

167 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

2060 Sam Rittenberg Blvd
Charleston, SC 29407-4616
Phone (843) 792-1414

Hospital & facility affiliations

  • Musc Medical Center Hospital, Charleston, SC, CCN 420004
  • Tidelands Waccamaw Community Hospital Hospital, Murrells Inlet, SC, CCN 420098
  • Tidelands Georgetown Memorial Hospital Hospital, Georgetown, SC, CCN 420020
  • Musc Health Columbia Medical Center Downtown Hospital, Columbia, SC, CCN 420026
  • Beaufort County Memorial Hospital Hospital, Beaufort, SC, CCN 420067

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5552SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Physician Assistant CurrentSince Oct 18, 2024 Accepting new patients

Locations

96 Jonathan Lucas St
Charleston, SC 29425
Phone (843) 792-3072

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

2060 Sam Rittenberg Blvd
Charleston, SC 29407
Phone (843) 876-0111

1600 Midtown Ave
Mt Pleasant, SC 29464
Phone (843) 284-6555

1122 Chuck Dawley Blvd
Bldg B
Mt Pleasant, SC 29464
Phone (843) 792-5434

Interoperability endpoints

  • Direct secure messaging: skirk430846@direct.musc.edu

Organizations & group practices 2

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1706659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1114780467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 JONATHAN LUCAS ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258900",
            "telephone_number": "864-792-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 JONATHAN LUCAS ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258900",
            "telephone_number": "864-792-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "SYDNEY",
        "middle_name": "ELYSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-31",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.