NPIMap

Individual provider Active NPI

Divya Koradia, MD

  • Family Medicine Physician
  • Erie, PA
National Provider Identifier
1134411051
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD453203 Issued in PA
Practice address
4247 W Ridge Rd Ste 105
Erie, PA 16506-1746
Phone
(814) 838-2468
Fax
(814) 835-4301
NPI assigned
May 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD453203 PA Primary

Addresses

Primary practice location

4247 W Ridge Rd Ste 105
Erie, PA 16506-1746

Mailing address

4247 W Ridge Rd Ste 105
Erie, PA 16506-1746
Phone (814) 838-2468

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dkoradia148839@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141201000905 PA Practitioner - Family Practice 3274855309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical Education and Research Institute IncGroup PAC ID 3870405137, 297 clinicians
Keystone Rehabilitation Systems IncGroup PAC ID 7012826753, shared by 15 NPIs, 750 clinicians

Practice addresses (Care Compare)

155 E State St
Albion Family Practice
Albion, PA 16401-1347
Phone (814) 756-4917

4247 W Ridge Rd
Erie, PA 16506-1746

5930 Old French Rd
Erie, PA 16509-3656
Phone (814) 860-7816

Hospital & facility affiliations

  • Allegheny Health Network Healthcare at Home Home H Home health agency, Warrendale, PA, CCN 398069
  • Visiting Nurse Association of Erie County Home health agency, Erie, PA, CCN 397034
  • Saint Vincent Hospital Hospital, Erie, PA, CCN 390009
  • Upmc Hamot Hospital, Erie, PA, CCN 390063

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Medical Education and Research Institute Inc Family Medicine CurrentSince Nov 3, 2014 Accepting new patients
Saint Vincent Medical Education and Research Institute Family Medicine Past Accepting new patients

Locations

155 E State St
Albion, PA 16401
Phone (814) 756-4917

2828 Sterrettania Rd
Erie, PA 16506
Phone (814) 833-9700

1910 Sassafras St
Ste 100
Erie, PA 16502
Phone (814) 452-5772

4247 W Ridge Rd
Ste 105
Erie, PA 16506
Phone (814) 453-7767

Organizations & group practices 2

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 5

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": "1305072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1134411051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4247 W RIDGE RD STE 105",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165061746",
            "telephone_number": "814-838-2468",
            "fax_number": "814-835-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4247 W RIDGE RD STE 105",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165061746",
            "telephone_number": "814-838-2468",
            "fax_number": "814-835-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORADIA",
        "first_name": "DIVYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-11",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD453203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dkoradia148839@direct.ahn.org",
            "affiliation": "N",
            "address_1": "4247 W Ridge Rd Ste 105",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165061746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.