Juliana Mavellia, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

94429 Issued in SC

Practice address

370 S Pike W
Sumter, SC 29150-2664

Phone

(803) 774-4500

Fax

(803) 774-4629

NPI assigned

Mar 30, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Pediatric Medicine

Education

Edward Via Col of Osteo Medicine-Carolinas Campus, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Tandem Health SC

  • Federally Qualified Health Center (FQHC)
  • Sumter, SC
  • NPI 1386630192
  Medicare reassignment NPD
• Tandem Health SC

  • Federally Qualified Health Center (FQHC)
  • Sumter, SC
  • NPI 1740641919
  NPD
• Tandem Health SC

  • Federally Qualified Health Center (FQHC)
  • Sumter, SC
  • NPI 1821885583
  NPD

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1457091373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S PIKE W",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502616",
            "telephone_number": "803-324-6975",
            "fax_number": "803-324-6975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 S PIKE W",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502664",
            "telephone_number": "803-774-4500",
            "fax_number": "803-774-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAVELLIA",
        "first_name": "JULIANA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-30",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "94429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "944296",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ciara Yassamyn Martinez
• Danielle Marx, LMSW
• Faith Mason, RBT
• Megan Lynn Mathis, BS, MOT, OTR/L
• Michele Mausolf, PTA
• Melissa Nickens McBride
• Mishana McCall
• Marcia McCammon
• Jennifer McCauley
• Sara K McClam, LISW AP CP

• Pediatrics Physician in Sumter, SC
• Providers in Sumter, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.