Sandeep Kumar Tiwari, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2003-00895 Issued in NC

Practice address

529 Becker Dr
Roanoke Rapids, NC 27870-3303

Phone

(252) 537-6465

Fax

(252) 535-0951

NPI assigned

Jan 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Park Avenue Pediatrics PA

  • Pediatrics Physician
  • Roanoke Rapids, NC
  • NPI 1417914797
  Medicare reassignment Authorized official
• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  Medicare reassignment NPD

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1669450458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 BECKER DR",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278703303",
            "telephone_number": "252-537-6465",
            "fax_number": "252-535-0951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 BECKER DR",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278703303",
            "telephone_number": "252-537-6465",
            "fax_number": "252-535-0951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIWARI",
        "first_name": "SANDEEP",
        "middle_name": "KUMAR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2023-03-07",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2003-00895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC MEDICAID PROVIDER #",
            "identifier": "1343W",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891343W",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC MEDICAL LICENSE #",
            "identifier": "2003-00895",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI PROVIDER #",
            "identifier": "3116888",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST LLC PROVIDER #",
            "identifier": "C9721",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas James Thiel, DC
• Thomas E Fleming DDS PA
• Alayna Ashley Thomas
• Joey P Thomas, M.D.
• Timothy Deans House LLC
• Brendina D Tobias, LCSW
• Kristen Elise Toth, RD, LDN
• Triumph LLC
• Triumph LLC
• Triumph LLC

• Pediatrics Physician in Roanoke Rapids, NC
• Providers in Roanoke Rapids, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.