Park Avenue Pediatrics PA
NPI 1417914797 · Pediatrics Physician · Roanoke Rapids, NC
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Park Avenue Pediatrics PA is a Pediatrics Physician organization in Roanoke Rapids, NC (NPI 1417914797).
Provider details
- NPI number
- 1417914797
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Sandeep Tiwari, President(252) 537-6465
- License
- 38443 (NC)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-04-28
- Last updated
- 2022-02-15
- Certified
- 2022-02-15
Frequently asked questions
- What is Park Avenue Pediatrics PA's NPI number?
- Park Avenue Pediatrics PA's National Provider Identifier (NPI) is 1417914797, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Park Avenue Pediatrics PA?
- Park Avenue Pediatrics PA is classified in the NPPES registry as Pediatrics Physician (Allopathic & Osteopathic Physicians).
- Where is Park Avenue Pediatrics PA located?
- Park Avenue Pediatrics PA's practice location on file with NPPES is 529 Becker Dr, Roanoke Rapids, NC 27870-3303.
- What is Park Avenue Pediatrics PA's phone number?
- The practice phone number listed in the NPPES registry for Park Avenue Pediatrics PA is (252) 537-6465.
- Does Park Avenue Pediatrics PA accept Medicare?
- Park Avenue Pediatrics PA is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Park Avenue Pediatrics PA?
- The authorized official listed on Park Avenue Pediatrics PA's NPPES record is Sandeep Tiwari, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Park Avenue Pediatrics PA's NPI active?
- Yes — Park Avenue Pediatrics PA's NPI (1417914797) is active in the NPPES registry as of the last update on 2022-02-15.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.