Individual provider Active NPI

Shivajirao Prakash Patil, M.D.

  • Family Medicine Physician
  • Greenville, NC
National Provider Identifier
1023339173
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2013-02228 Issued in NC
Practice address
101 Heart Dr
Greenville, NC 27834-8982
Phone
(252) 744-4611
Fax
(252) 744-3040
NPI assigned
Jun 11, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2013-02228 NC Primary
Diabetology (Family Medicine) Physician 207QD0401X 2013-02228 NC

Addresses

Primary practice location

101 Heart Dr
Greenville, NC 27834-8982

Mailing address

PO Box 751069
Charlotte, NC 28275-1069

Other identifiers 2

IdentifierTypeStateIssuer
1867EOtherNCBCBS NC
1023339173MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address spatil23330@direct.ecuhealth.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20140926000259 NC Practitioner - Family Practice 4183844152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
East Carolina UniversityGroup PAC ID 0244143246, 499 clinicians

Practice addresses (Care Compare)

101 Heart Dr
Greenville, NC 27834-8982
Phone (252) 744-3109

115 Heart Dr
Greenville, NC 27834-8982
Phone (252) 744-4400

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 209-3000

600 Moye Blvd
Greenville, NC 27834-4300
Phone (252) 744-4611

Hospital & facility affiliations

  • Ecu Health Medical Center Hospital, Greenville, NC, CCN 340040

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013-02228NCMDMedical license number

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina University Family Medicine CurrentSince Jul 16, 2014 Accepting new patients
East Carolina University CurrentSince Jul 16, 2014 Accepting new patients

Locations

101 Heart Dr
Greenville, NC 27834
Phone (252) 744-4611

600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111

Interoperability endpoints

  • Direct secure messaging: spatil23330@direct.ecuhealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1023339173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751069",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HEART DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278348982",
            "telephone_number": "252-744-4611",
            "fax_number": "252-744-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATIL",
        "first_name": "SHIVAJIRAO",
        "middle_name": "PRAKASH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-11",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2013-02228",
            "primary": true
        },
        {
            "code": "207QD0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Diabetology",
            "state": "NC",
            "license": "2013-02228",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "1867E",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023339173",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spatil23330@direct.ecuhealth.com",
            "affiliation": "N",
            "endpointDescription": "ECU Physicians",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "101 Heart Dr",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278348982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.