Divya Baker
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Gloversville, NY
NPI 1154934263 · NPPES record last updated May 23, 2025
Key facts
- NPI
- 1154934263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 774828 (NY)
- Practice address
- 127 E State St
Gloversville, NY 12078-1204 - Phone
- (518) 773-7931
- Fax
- (518) 930-4152
- NPI assigned
- Aug 28, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St. Mary'S Healthcare
Practice addresses (Care Compare)
4988 State Hwy 30
Amsterdam, NY 12010-7520
Phone (518) 843-4410
Hospital & facility affiliations
- St Marys Healthcare
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250922000540 | NY | Practitioner - Nurse Practitioner | 0244734259 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0678541 | NY | MD | Case Management Registered Nurse |
| 774828 | NY | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Marys Healthcare | Current |
Accepting new patients | |
| St. Mary'S Healthcare | Current |
Accepting new patients |
Locations
4988 State Highway 30
Amsterdam, NY 12010
Phone (518) 842-3100
380 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 841-7415
427 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 442-1404
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Registered Nurse | 163WC0400X | 0678541 | NY | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 774828 | NY | Yes |
Addresses
Primary practice location
127 E State St
Gloversville, NY 12078-1204
Mailing address
127 E State St
Gloversville, NY 12078-1204
Phone (518) 448-2721
Other providers in Gloversville, NY
- Carrie Baeza
- Alexander Bagdovitz
- George Fredrick Bahr IV
- Billie Jo Baird
- Crystal M Baker
- Kristen M Baker
- Stephanie Bakyta
- Balanced Health Physical Therapy
- Clifford Keith Balch
- Sandra Ellan Baldwin
All providers in Gloversville, NY · Psychiatric/Mental Health Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 23, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.