Active NPI
Cristina Diventi, LSW
- Social Worker
- Rockford, IL
National Provider Identifier
1013363290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150101625
- Practice address
- 1200 W State St
Rockford, IL 61102-2112 - Phone
- (815) 490-1600
- Fax
- (815) 490-1881
- NPI assigned
- May 6, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 150101625 | IL | Primary |
Addresses
Primary practice location
1200 W State St
Rockford, IL 61102-2112
Mailing address
1200 W State St
Rockford, IL 61102-2112
Phone (815) 490-1600
Other practice location 1
1050 Logan Ave
Belvidere, IL 61008-3966
Phone (815) 490-1600
Other names 1
- Cristina A Becerra
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190517000378 | IL | Order and Referring Only - Clinical Social Worker | 9032452883 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crusaders Central Clinic Association | Past | Accepting new patients |
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.
-
- Federally Qualified Health Center (FQHC)
- Rockford, IL
- NPI 1902972557
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561939200000",
"number": "1013363290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 W STATE ST",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611022112",
"telephone_number": "815-490-1600",
"fax_number": "815-490-1845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 W STATE ST",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611022112",
"telephone_number": "815-490-1600",
"fax_number": "815-490-1881"
}
],
"practiceLocations": [
{
"address_1": "1050 Logan Ave",
"address_purpose": "LOCATION",
"city": "Belvidere",
"state": "IL",
"postal_code": "610083966",
"country_code": "US",
"telephone_number": "815-490-1600",
"fax_number": "815-490-1881",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIVENTI",
"first_name": "CRISTINA",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-06",
"last_updated": "2019-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150101625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CRISTINA",
"last_name": "BECERRA",
"middle_name": "A",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; 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.