Individual provider Active NPI

James Sierakowski, DO

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Greenville, SC
National Provider Identifier
1346539004
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
39919 Issued in SC
Practice address
701 Grove Rd
Greenville, SC 29605-4210
Phone
(864) 455-7000
NPI assigned
Apr 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 39919 SC Primary
Pediatrics Physician 208000000X OS12748 FL
Pediatrics Physician 208000000X 39919 SC
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

701 Grove Rd
Greenville, SC 29605-4210

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

807 Childrens Way
Jacksonville, FL 32207-8426
Phone (904) 697-3032

Other identifiers 1

IdentifierTypeStateIssuer
399198MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jsierakowski170884@direct.ghs.myhfn.org Direct

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
I20170727000385 SC Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 5698993657 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39919SCMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health-Upstate CurrentSince Jul 17, 2017 Accepting new patients
Musc Affiliate Physicians CurrentSince Mar 7, 2023 Accepting new patients
Prisma Health-Upstate Current Accepting new patients
Musc Affiliate Physicians Pediatrics CurrentSince Mar 7, 2023 Accepting new patients
Prisma Health-Upstate CurrentSince Jul 17, 2017 Accepting new patients
University Medical Associates Past Accepting new patients

Locations

22725 US Highway 76
Clinton, SC 29325
Phone (864) 833-9100

525 Verdae Blvd
#100
Greenville, SC 29607
Phone (864) 516-2800

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

9 Hawthorne Park Ct
Greenville, SC 29615
Phone (864) 286-1040

525 Verdae Blvd
#200
Greenville, SC 29607
Phone (864) 603-5600

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

830 S Buncombe Rd
Greer, SC 29650
Phone (864) 797-8000

145 E Poinsett St
Greer, SC 29651
Phone 86460356003222

30 Halter Dr
Powdersville, SC 29673

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

559 Harrison Bridge Rd
Simpsonville, SC 29680

729 SE Main St
Simpsonville, SC 29681
Phone (864) 271-8647

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

Interoperability endpoints

  • Direct secure messaging: jsierakowski170884@direct.ghs.myhfn.org
  • Direct secure messaging: jsierakowski33850@direct.nemours.org

Organizations & group practices 6

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": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1346539004",
    "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",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GROVE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054210",
            "telephone_number": "864-455-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "807 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078426",
            "country_code": "US",
            "telephone_number": "904-697-3032",
            "fax_number": "904-697-3011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIERAKOWSKI",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-04",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "SC",
            "license": "39919",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS12748",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "39919",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "399198",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsierakowski170884@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jsierakowski170884@direct.ghs.myhfn.org",
            "address_1": "701 Grove Rd",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296054210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.