Individual provider Active NPI

Sydney Renee Nidiffer, PA-C

  • Physician Assistant
  • Columbia, SC
National Provider Identifier
1861101321
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4660 Issued in SC
Practice address
220 Graces Way
Columbia, SC 29229-1613
Phone
(803) 736-4560
NPI assigned
Nov 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4660 SC Primary

Addresses

Primary practice location

220 Graces Way
Columbia, SC 29229-1613

Mailing address

220 Graces Way
Columbia, SC 29229-1613
Phone (803) 736-4560

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221223001226 SC Practitioner - Physician Assistant 3870963432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Dermatology GRPGroup PAC ID 3274557384, 27 clinicians

Practice addresses (Care Compare)

220 Graces Way
Columbia, SC 29229-1613
Phone (803) 771-7506

Merit-based Incentive Payment System (MIPS)

Final score
85.11 of 100Reported as group
Quality
84.56
Promoting interoperability
74
Improvement activities
40
Cost
87.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4460SCMDGeneral Practice Dentistry
4660SCMDSpeech-Language Pathologist

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1669075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1861101321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 GRACES WAY",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292291613",
            "telephone_number": "803-736-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 GRACES WAY",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292291613",
            "telephone_number": "803-736-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIDIFFER",
        "first_name": "SYDNEY",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-22",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.