Devine Concierge Medicine, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

DEVINE CONCIERGE MEDICINE, LLC

Doing business as

Devine Concierge Medicine

Practice address

165 Ridgewood Rd
Wayne, PA 19087-2846

Phone

(610) 554-5626

NPI assigned

Jul 30, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Daniel J. Devine, MD

Title

Co-Founder

Phone

(610) 554-5626

Specialties & licenses 1

Addresses

Other names 1

• Devine Concierge Medicine Doing business as

Electronic endpoints 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596585600000",
    "number": "1093324527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 SOUTH WAYNE AVENUE, P.O. BOX #279",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "19087",
            "telephone_number": "610-554-5626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 RIDGEWOOD RD",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190872846",
            "telephone_number": "610-554-5626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVINE CONCIERGE MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-30",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A",
        "authorized_official_last_name": "DEVINE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CO-FOUNDER",
        "authorized_official_telephone_number": "610-554-5626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://app.elationemr.com/",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "165 Ridgewood Rd",
            "city": "Wayne",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190872846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Devine Concierge Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megan Delaney, OTR/L
• Paula Thomas Delong, MA
• Suzanne Polcyn Deluca, PT
• Nathanael Desantana, MS
• Julia Rose Dethlefs, DPT
• Michael S. Devine, M.D.
• Karen L Dewane, PT
• Hadiatou Diallo
• Kathleen Difebo, OT
• Paula Difrancesco, LICENSED MASSAGE

• Internal Medicine Physician in Wayne, PA
• Providers in Wayne, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.