Individual provider Active NPI

Sydney Gualtieri

  • Pediatrics Physician
  • Sumter, SC
National Provider Identifier
1215632617
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
89721 Issued in SC
Practice address
129 N Washington St
Sumter, SC 29150-4949
Phone
(803) 774-9680
Fax
(803) 434-3955
NPI assigned
Apr 4, 2023
Last updated
Jul 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 89721 SC Primary

Addresses

Primary practice location

129 N Washington St
Sumter, SC 29150-4949

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842

Other practice location 1

9 Richland Medical Park Dr
Columbia, SC 29203-6859
Phone (803) 434-7606

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
I20260611002881 SC Practitioner - Pediatric Medicine 9537522768

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
West Virginia School of Osteopathic Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

300 E McBee Ave
Greenville, SC 29601-2842

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Allergy & Asthma PA CurrentSince Apr 9, 2023 Accepting new patients

Locations

9 Richland Medical Park Dr
Columbia, SC 29203
Phone (803) 434-7606

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1215632617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 N WASHINGTON ST",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504949",
            "telephone_number": "803-774-9680",
            "fax_number": "803-434-3955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9 Richland Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036859",
            "country_code": "US",
            "telephone_number": "803-434-7606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUALTIERI",
        "first_name": "SYDNEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-04",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "89721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

Verify at the official NPI Registry.