Individual provider Active NPI

Michelle Irene Amaya, M.D.

  • Pediatrics Physician
  • Charleston, SC
National Provider Identifier
1568489557
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
31238 Issued in SC
Practice address
171 Ashley Ave
Charleston, SC 29425-0100
Phone
(843) 792-1414
Fax
(843) 792-1827
NPI assigned
Jul 16, 2006
Last updated
May 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 31238 SC Primary
Pediatrics Physician 208000000X 17476 AL
Child Abuse Pediatrics Physician 2080C0008X 31238 SC

Addresses

Primary practice location

171 Ashley Ave
Charleston, SC 29425-0100

Mailing address

PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-6200

Other identifiers 6

IdentifierTypeStateIssuer
000028985MedicaidAL
312389MedicaidSC
009999735MedicaidAL
510-24694OtherALBC BS
000024694MedicaidAL
F61561OtherVIVA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

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
I20081010000780 SC Practitioner - Pediatric Medicine 1951479377 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31238SCMDAdministrator Registered Nurse
17476ALMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Pediatrics CurrentSince Feb 10, 2018 Accepting new patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Feb 10, 2018 Accepting new patients
Medical University Hospital Authority Past Accepting new patients

Locations

10 McClennan Banks Dr
Charleston, SC 29401
Phone (843) 330-9824

135 Rutledge Ave
Charleston, SC 29425
Phone (803) 569-1757

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

Interoperability endpoints

  • Direct secure messaging: mamaya5023@direct.musc.edu

Organizations & group practices 4

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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1568489557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-6200",
            "fax_number": "843-792-1827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294250100",
            "telephone_number": "843-792-1414",
            "fax_number": "843-792-1827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMAYA",
        "first_name": "MICHELLE",
        "middle_name": "IRENE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "31238",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "17476",
            "primary": false
        },
        {
            "code": "2080C0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Child Abuse Pediatrics",
            "state": "SC",
            "license": "31238",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000028985",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "312389",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009999735",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "510-24694",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000024694",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIVA",
            "identifier": "F61561",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "171 Ashley Ave",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294250100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.