Individual provider Active NPI

Amanda Ruscin Vartanian, M.D.

  • Pediatrics Physician
  • Lexington, SC
National Provider Identifier
1205249117
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
LL36978 Issued in SC
Practice address
811 W Main St Ste 204
Lexington, SC 29072-2500
Phone
(803) 359-8855
Fax
(803) 359-1257
NPI assigned
Jun 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X LL36978 SC Primary
Pediatrics Physician 208000000X 36978 SC

Addresses

Primary practice location

811 W Main St Ste 204
Lexington, SC 29072-2500

Mailing address

PO Box 6069
West Columbia, SC 29171-6069

Other practice location 1

4080 Augusta Hwy Ste 100
Gilbert, SC 29054-8893
Phone (803) 892-1800

Other practice location 2

3240 Sunset Blvd
West Columbia, SC 29169-3428
Phone (803) 359-8855

Other practice location 3

4080 Augusta Hwy Ste 100
Gilbert, SC 29054-8893
Phone (803) 892-1800

Other practice location 4

14 Medical Park, Ste 400
Children's Hospital Outpatient Center
Columbia, SC 29203
Phone (803) 434-6155

Other practice location 5

14 Medical Park, Ste 400
Children's Hospital Outpatient Center
Columbia, SC 29203
Phone (803) 434-6155

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address avartanian69231@direct.lexmed.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210205001564 SC Practitioner - Pediatric Medicine 7618263435 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Health Inc CurrentSince Feb 1, 2021 Accepting new patients
Lexington Health Inc Current Accepting new patients
Lexington County Health Services District Inc Current Accepting new patients
Lexington Health Inc CurrentSince Feb 1, 2021 Accepting new patients
Lexington County Health Services District, Inc. Past Accepting new patients

Locations

811 W Main St
Ste 204
Lexington, SC 29072
Phone (803) 358-6420

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

3240 Sunset Blvd
West Columbia, SC 29169
Phone (803) 359-8855

Interoperability endpoints

  • Direct secure messaging: avartanian69231@direct.lexmed.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1205249117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291716069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 W MAIN ST STE 204",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290722500",
            "telephone_number": "803-359-8855",
            "fax_number": "803-359-1257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4080 Augusta Hwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "SC",
            "postal_code": "290548893",
            "country_code": "US",
            "telephone_number": "803-892-1800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3240 Sunset Blvd",
            "address_purpose": "LOCATION",
            "city": "West Columbia",
            "state": "SC",
            "postal_code": "291693428",
            "country_code": "US",
            "telephone_number": "803-359-8855",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4080 Augusta Hwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "SC",
            "postal_code": "290548893",
            "country_code": "US",
            "telephone_number": "803-892-1800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14 Medical Park, Ste 400",
            "address_2": "Children's Hospital Outpatient Center",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "29203",
            "country_code": "US",
            "telephone_number": "803-434-6155",
            "fax_number": "803-434-6979",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14 Medical Park, Ste 400",
            "address_2": "Children's Hospital Outpatient Center",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "29203",
            "country_code": "US",
            "telephone_number": "803-434-6155",
            "fax_number": "803-434-6979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VARTANIAN",
        "first_name": "AMANDA",
        "middle_name": "RUSCIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "LL36978",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "36978",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "avartanian69231@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "811 W Main St Ste 204",
            "city": "Lexington",
            "state": "SC",
            "country_code": "US",
            "postal_code": "290722500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

Verify at the official NPI Registry.