Individual provider Active NPI

Mariya Zyablitskaya, MD

  • Internal Medicine Physician
  • Tarboro, NC
National Provider Identifier
1083378947
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
202500081 Issued in NC
Practice address
111 Hospital Dr
Tarboro, NC 27886-2011
Phone
(252) 847-5652
NPI assigned
Oct 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 202500081 NC Primary

Addresses

Primary practice location

111 Hospital Dr
Tarboro, NC 27886-2011

Mailing address

965 Spring Forest Rd Apt A5
Greenville, NC 27834-4996
Phone (917) 854-6787

Other practice location 1

Maimonides Medical Center
4802 10th Ave
Brooklyn, NY 11219-2916
Phone (718) 283-6000

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
I20250327002053 NC Practitioner - Internal Medicine 4284157504 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

111 Hospital Dr
Tarboro, NC 27886-2011
Phone (252) 641-8585

Hospital & facility affiliations

  • Vidant Edgecombe Hospital Hospital, Tarboro, NC, CCN 340107
  • Ecu Health Medical Center Hospital, Greenville, NC, CCN 340040

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202500081NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Outer Banks Professional Services, LLC Internal Medicine CurrentSince Mar 3, 2025 Accepting new patients
Outer Banks Professional Services, LLC CurrentSince Mar 3, 2025 Accepting new patients

Locations

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

4800 S Croatan Hwy
Nags Head, NC 27959
Phone (252) 449-4500

5565 N Croatan Hwy
Southrn Shore, NC 27949
Phone (252) 261-5800

111 Hospital Dr
Tarboro, NC 27886
Phone (252) 641-7700

Interoperability endpoints

  • Direct secure messaging: mariya.zyablitskaya.p1@direct.mmc.nextgenshare.com

Organizations & group practices 3

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 3

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": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1083378947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 SPRING FOREST RD APT A5",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278344996",
            "telephone_number": "917-854-6787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HOSPITAL DR",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278862011",
            "telephone_number": "252-847-5652"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Maimonides Medical Center",
            "address_2": "4802 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112192916",
            "country_code": "US",
            "telephone_number": "718-283-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZYABLITSKAYA",
        "first_name": "MARIYA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-27",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "202500081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarboro, NC

Sources for this page

Verify at the official NPI Registry.