Individual provider Active NPI

Michael Anthony Sierra, M.D.

  • Child & Adolescent Psychiatry Physician
  • Greenville, SC
National Provider Identifier
1720491640
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
36956 Issued in SC
Practice address
200 Patewood Dr Ste A100
Greenville, SC 29615-6302
Phone
(864) 454-5612
Fax
(864) 454-5121
NPI assigned
Jun 9, 2014
Last updated
May 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 36956 SC
Psychiatry Physician 2084P0800X LL36956 SC
Child & Adolescent Psychiatry Physician 2084P0804X 36956 SC Primary

Addresses

Primary practice location

200 Patewood Dr Ste A100
Greenville, SC 29615-6302

Mailing address

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

Other practice location 1

124 Mallard St
Greenville, SC 29601-4046
Phone (864) 241-1040

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address msierra264028@direct.ghs.myhfn.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL36956SCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health-Upstate Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: msierra264028@direct.ghs.myhfn.org

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": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1720491640",
    "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": "200 PATEWOOD DR STE A100",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156302",
            "telephone_number": "864-454-5612",
            "fax_number": "864-454-5121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "124 Mallard St",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296014046",
            "country_code": "US",
            "telephone_number": "864-241-1040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIERRA",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-09",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "36956",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "LL36956",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "SC",
            "license": "36956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msierra264028@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "msierra264028@direct.ghs.myhfn.org",
            "address_1": "200 Patewood Dr Ste A100",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296156302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.