Individual provider Active NPI

Tjuana Faith Durden Seidl, PA-C

  • Medical Physician Assistant
  • Lexington, SC
National Provider Identifier
1912378290
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2378 Issued in SC
Practice address
468 Old Cherokee Rd
Lexington, SC 29072-9031
Phone
(803) 970-6972
Fax
(839) 218-5344
NPI assigned
Oct 13, 2015
Last updated
Apr 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2378 SC
Medical Physician Assistant 363AM0700X 2378 SC Primary

Addresses

Primary practice location

468 Old Cherokee Rd
Lexington, SC 29072-9031

Mailing address

407 Reedy River CT
Lexington, SC 29073-9630
Phone (803) 646-0126

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
I20151209000618 SC Practitioner - Physician Assistant 9739480161 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Age Well SC LLCGroup PAC ID 4981127719, 2 clinicians

Practice addresses (Care Compare)

468 Old Cherokee Rd
Lexington, SC 29072-9031
Phone (803) 970-6972

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2378SCMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Musc Community Physicians CurrentSince Mar 1, 2023 Accepting new patients
Musc Community Physicians CurrentSince Mar 1, 2023 Accepting new patients
Edisto Regional Health Services Inc CurrentSince Feb 1, 2017 Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

187 Bunch Ford Rd
Holly Hill, SC 29059
Phone (803) 395-3068

1137 Cook Rd
Orangeburg, SC 29118
Phone (803) 395-2579

1175 Cook Rd
Ste 225
Orangeburg, SC 29118
Phone (803) 395-3430

3000 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 395-2200

Organizations & group practices 5

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": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1912378290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 REEDY RIVER CT",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290739630",
            "telephone_number": "803-646-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "468 OLD CHEROKEE RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290729031",
            "telephone_number": "803-970-6972",
            "fax_number": "839-218-5344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURDEN SEIDL",
        "first_name": "TJUANA",
        "middle_name": "FAITH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-13",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2378",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "2378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

Verify at the official NPI Registry.