Individual provider Active NPI

Manisha Tiwari, M.D.

  • Internal Medicine Physician
  • Tarboro, NC
National Provider Identifier
1265786115
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2017-00245 Issued in NC
Practice address
101 Clinic Dr
Tarboro, NC 27886-1935
Phone
(212) 423-6771
NPI assigned
Oct 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2017-00245 NC Primary

Addresses

Primary practice location

101 Clinic Dr
Tarboro, NC 27886-1935

Mailing address

1005 Saint Andrew St
Tarboro, NC 27886-3842
Phone (646) 468-1166

Other identifiers 1

IdentifierTypeStateIssuer
932281217OtherNYGHI BLUE CROSS BLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mtiwari250258@direct.vidanthealth.com

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
I20170620001046 NC Practitioner - Internal Medicine 5395013155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

101 Clinic Dr
Tarboro, NC 27886-1935
Phone (252) 823-2105

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Rocky Mount, NC, CCN 347328
  • Vidant Edgecombe Hospital Hospital, Tarboro, NC, CCN 340107

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017-00245NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince May 1, 2017 Accepting new patients

Locations

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

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

101 Clinic Dr
Tarboro, NC 27886
Phone (252) 823-2105

Interoperability endpoints

  • Direct secure messaging: mtiwari250258@direct.vidanthealth.com

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.

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": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1265786115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 SAINT ANDREW ST",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278863842",
            "telephone_number": "646-468-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CLINIC DR",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278861935",
            "telephone_number": "212-423-6771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIWARI",
        "first_name": "MANISHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-30",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2017-00245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI BLUE CROSS BLUE SHIELD",
            "identifier": "932281217",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mtiwari250258@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tarboro, NC

Sources for this page

Verify at the official NPI Registry.