Diverge Health Ipa of Ny LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

DIVERGE HEALTH IPA OF NY LLC

Practice address

500 Adams Ave
Glencoe, IL 60022-1865

Phone

(941) 718-9000

NPI assigned

Mar 8, 2024

Last updated

Apr 8, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vincent Pantone, MDNPI 1710150263

Title

Cmo

Phone

(941) 917-9000

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vincent Pantone, M.D.

  • Internal Medicine Physician
  • Sarasota, FL
  • NPI 1710150263
  Authorized official Same address or phone

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

{
    "created_epoch": "1709856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1033977665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ADAMS AVE",
            "city": "GLENCOE",
            "state": "IL",
            "postal_code": "600221865",
            "telephone_number": "941-718-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ADAMS AVE",
            "city": "GLENCOE",
            "state": "IL",
            "postal_code": "600221865",
            "telephone_number": "941-718-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERGE HEALTH IPA OF NY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-08",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A",
        "authorized_official_last_name": "PANTONE",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "941-917-9000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Juliette Rachel Ellis, P.T.

• Case Management Agency in Glencoe, IL
• Providers in Glencoe, IL by specialty
• Case Management Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.