NPIMap

Individual provider Active NPI

Satyanarayana Rao Vaidya, MD

  • Internal Medicine Physician
  • Carbondale, IL
National Provider Identifier
1548410095
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036127222 Issued in IL
Practice address
405 W Jackson
Carbondale, IL 62901
Phone
(618) 549-0721
Fax
(618) 529-0449
NPI assigned
Sep 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036127222 IL Primary
Internal Medicine Physician 207R00000X 4301092793 MI
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 2015-01269 NC
Internal Medicine Physician 207R00000X 2015-01269 NC

Addresses

Primary practice location

405 W Jackson
Carbondale, IL 62901

Mailing address

603 Skyline Drive
Apt #2
Marion, IL 62959
Phone (616) 206-1270

Other practice location 1

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-7392

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150813011199 NC Practitioner - Internal Medicine 6406025204 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cumberland County Hospital System IncGroup PAC ID 1850204041, 581 clinicians

Practice addresses (Care Compare)

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-5610

Hospital & facility affiliations

  • Cape Fear Valley Medical Center Hospital, Fayetteville, NC, CCN 340028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036127222ILMDInternal Medicine Physician
4301092793MIMDInternal Medicine Physician
2015-01269NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Regional Medical Center CurrentSince Aug 24, 2023 Accepting new patients
Cumberland County Hospital System Inc CurrentSince Oct 28, 2021 Accepting new patients
Cumberland County Hospital System Inc Current Accepting new patients
Cumberland County Hospital System Inc Critical Care Medicine CurrentSince Oct 28, 2021 Accepting new patients
Southeastern Regional Medical Center CurrentSince Aug 24, 2023 Accepting new patients
Apogee Medical Group North Carolina CurrentSince Jul 1, 2015 Accepting new patients
Southeastern Regional Medical Center Current Accepting new patients

Locations

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

300 W 27th St
Lumberton, NC 28358
Phone (910) 671-5000

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

Interoperability endpoints

  • Direct secure messaging: svaidya92371@capefearvalley.direct-ci.com

Organizations & group practices 7

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1222041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1548410095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 SKYLINE DRIVE",
            "address_2": "APT #2",
            "city": "MARION",
            "state": "IL",
            "postal_code": "62959",
            "telephone_number": "616-206-1270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W JACKSON",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "62901",
            "telephone_number": "618-549-0721",
            "fax_number": "618-529-0449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1638 Owen Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043424",
            "country_code": "US",
            "telephone_number": "910-615-7392",
            "fax_number": "910-615-7633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAIDYA",
        "first_name": "SATYANARAYANA",
        "middle_name": "RAO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-22",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036127222",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301092793",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NC",
            "license": "2015-01269",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2015-01269",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.