Individual provider Active NPI

Shaivya Pathak, MD

  • Hospitalist Physician
  • Tarboro, NC
National Provider Identifier
1821551052
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
202201777 Issued in NC
Practice address
111 Hospital Dr
Tarboro, NC 27886-2011
Phone
(252) 641-7700
NPI assigned
Apr 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 202201777 NC Primary
Student in an Organized Health Care Education/Training Program 390200000X NC
Internal Medicine Physician 207R00000X RTL19-0853 NC

Addresses

Primary practice location

111 Hospital Dr
Tarboro, NC 27886-2011

Mailing address

111 Hospital Dr
Tarboro, NC 27886-2011
Phone (252) 641-7700

Other practice location 1

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 744-3229

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address spathak289706@direct.ecuhealth.com Health Information Exchange (HIE)
Direct Messaging Address spathak289706@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
I20220809003546 NC Practitioner - Internal Medicine 5193052868 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians
East Carolina UniversityGroup PAC ID 0244143246, 499 clinicians

Practice addresses (Care Compare)

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

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

Hospital & facility affiliations

  • Vidant Edgecombe Hospital Hospital, Tarboro, NC, CCN 340107
  • 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
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RTL19-0853NCMDInternal Medicine Physician
202201777NCMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Outer Banks Professional Services, LLC Internal Medicine CurrentSince Jul 26, 2022 Accepting new patients
Vidant Medical Group LLC CurrentSince Jun 22, 2022 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

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: spathak289706@direct.ecuhealth.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": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1821551052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HOSPITAL DR",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278862011",
            "telephone_number": "252-641-7700"
        },
        {
            "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": "252-641-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Stantonsburg Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278342818",
            "country_code": "US",
            "telephone_number": "252-744-3229",
            "fax_number": "252-744-3924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATHAK",
        "first_name": "SHAIVYA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-14",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "202201777",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "RTL19-0853",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spathak289706@direct.ecuhealth.com",
            "affiliation": "N",
            "endpointDescription": "ECU Physicians",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spathak289706@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.