Individual provider Active NPI

Thomas V Divinagracia, M.D.

  • Vascular Surgery Physician
  • Hartford, CT
National Provider Identifier
1083859649
Registry record updated Mar 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
046129 Issued in CT
Practice address
85 Seymour St.
Suite 409
Hartford, CT 06106
Phone
(860) 522-4158
Fax
(860) 524-2652
NPI assigned
Dec 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 046129 CT
Surgery Physician 208600000X 046129 CT
Vascular Surgery Physician 2086S0129X 046129 CT Primary

Addresses

Primary practice location

85 Seymour St.
Suite 409
Hartford, CT 06106

Mailing address

85 Seymour St.
Suite 409
Hartford, CT 06106
Phone (860) 522-4158

Other identifiers 18

IdentifierTypeStateIssuer
061406459OtherCTPRIVATE HEALTHCARE SYSTEMS
1083859649OtherCTANTHEM BCBS
3V3712OtherCTHEALTH NET
06-1406459OtherCTPIONEER
06-1406459OtherCTGREAT-WEST HEALTHCARE
06-1406459OtherCTCORVEL
1083859649MedicaidCT
1083859649OtherCTAETNA
46286OtherCTHEALTH NEW ENGLAND
P4028934OtherCTOXFORD
046129OtherCTCONNECTICARE
06-1406459OtherCTMULTIPLAN
508455OtherCTWELLCARE
06-1406459OtherCTUNITED HEALTHCARE
06-1406459OtherCTNORTHEAST HEALTH DIRECT
06-1406459OtherCTTRICARE
06-1406459OtherCTCOMMUNITY HEALTH NETWORK
7299062OtherCTCIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20090611000402 CT Practitioner - Vascular SurgeryPractitioner - General SurgeryPractitioner - Diagnostic RadiologyPractitioner - Peripheral Vascular DiseasePractitioner - Interventional Radiology 0648320754 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: Diagnostic Radiology, General Surgery, Interventional Radiology, Peripheral Vascular Disease
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

85 Seymour St
Suite 409
Hartford, CT 06106-5523
Phone (860) 522-4158

Hospital & facility affiliations

  • Hartford Hospital Hospital, Hartford, CT, CCN 070025

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Leg revascularization (restoring blood flow)15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
046129CTMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC Surgery CurrentSince Jun 1, 2019 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jun 1, 2019 Accepting new patients
Hartford Healthcare Medical Group, Inc Vascular & Interventional Radiology CurrentSince Jan 1, 2013 Accepting new patients
Hartford Clinical Associates, P.C. Vascular & Interventional Radiology Past Accepting new patients

Locations

330 Western Blvd
Glastonbury, CT 06033
Phone (860) 524-4566

85 Seymour St
Ste 301
Hartford, CT 06106
Phone (860) 696-2030

85 Seymour St
Ste 409
Hartford, CT 06106
Phone (860) 522-4158

85 Seymour St
Ste 416
Hartford, CT 06106
Phone (860) 522-4158

201 N Mountain Rd
Ste 201
Plainville, CT 06062
Phone (860) 223-0800

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Fl 2
Wethersfield, CT 06109
Phone (860) 224-5305

Interoperability endpoints

  • Direct secure messaging: thomas.divinagracia@xdr.hhchealthdirect.org

Organizations & group practices 4

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 2

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": "1228953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1083859649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 SEYMOUR ST.",
            "address_2": "SUITE 409",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06106",
            "telephone_number": "860-522-4158",
            "fax_number": "860-524-2652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 SEYMOUR ST.",
            "address_2": "SUITE 409",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06106",
            "telephone_number": "860-522-4158",
            "fax_number": "860-524-2652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVINAGRACIA",
        "first_name": "THOMAS",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-11",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CT",
            "license": "046129",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "046129",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CT",
            "license": "046129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEMS",
            "identifier": "061406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "1083859649",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "3V3712",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIONEER",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT-WEST HEALTHCARE",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORVEL",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083859649",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1083859649",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NEW ENGLAND",
            "identifier": "46286",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P4028934",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "046129",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "508455",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTHEAST HEALTH DIRECT",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY HEALTH NETWORK",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7299062",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.