Individual provider Active NPI

Timothy D Divens, MD

  • Diagnostic Radiology Physician
  • Indianapolis, IN
National Provider Identifier
1164416475
Registry record updated Dec 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
01050545A Issued in IN
Practice address
9998 Crosspoint Blvd Ste 200
Indianapolis, IN 46256-3307
Phone
(317) 579-2150
Fax
(317) 579-2130
NPI assigned
Sep 1, 2005
Last updated
Dec 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 1050545 IN
Diagnostic Radiology Physician 2085R0202X 01050545A IN Primary
Vascular & Interventional Radiology Physician 2085R0204X 01050545A IN

Addresses

Primary practice location

9998 Crosspoint Blvd Ste 200
Indianapolis, IN 46256-3307

Mailing address

9998 Crosspoint Blvd
Ste 200
Indianapolis, IN 46256-3307
Phone (317) 579-2150

Other identifiers 17

IdentifierTypeStateIssuer
000000204809OtherINANTHEM
300138597OtherRAILROAD MEDICARE
P00024122OtherRAILROAD MEDICARE
P00024421OtherRAILROAD MEDICARE
P00346514OtherRAILROAD MEDICARE
P00023584OtherRAILROAD MEDICARE
P00023634OtherRAILROAD MEDICARE
P00024260OtherRAILROAD MEDICARE
P00023583OtherRAILROAD MEDICARE
P00024059OtherRAILROAD MEDICARE
P00024079OtherRAILROAD MEDICARE
P00024419OtherRAILROAD MEDICARE
300124562OtherINRAILROAD MEDICARE
20025310AMedicaidIN
P00023585OtherRAILROAD MEDICARE
P000233634OtherRAILROAD MEDICARE
P00023582OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20050524000287 IN Practitioner - Diagnostic RadiologyPractitioner - Internal Medicine 1052353786 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wayne State University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Decatur County Memorial HospitalGroup PAC ID 7315837671, 128 clinicians
Radiology of Indiana P CGroup PAC ID 0648161430, 122 clinicians

Practice addresses (Care Compare)

720 N Lincoln St
Greensburg, IN 47240-1327
Phone (812) 663-4331

9998 Crosspoint Blvd
Suite 200
Indianapolis, IN 46256-3307
Phone (317) 579-2150

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1050545INMDDiagnostic Radiology Physician
01050545AINMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hancock Health Gateway Services Inc CurrentSince Sep 11, 2019 Accepting new patients
Decatur County Memorial Hospital CurrentSince Jan 1, 2025 Accepting new patients
Decatur County Memorial Hospital CurrentSince May 27, 2025 Accepting new patients
Decatur County Memorial Hospital CurrentSince Jan 1, 2025 Accepting new patients
Radiology of Indiana P C Diagnostic Radiology CurrentSince Oct 1, 2001 Accepting new patients
American Health Network of Indiana, LLC Diagnostic Radiology Past Accepting new patients
Hancock Health Gateway Services, Inc. Past Accepting new patients

Locations

26 Six Pine Ranch Rd
Batesville, IN 47006
Phone (812) 934-5252

6189 W John L Modglin Dr
Ste 103
Greenfield, IN 46140
Phone (317) 866-7301

720 N Lincoln St
Greensburg, IN 47240
Phone (812) 522-2349

7340 Shadeland Sta
Ste 200
Indianapolis, IN 46256

9998 Crosspoint Blvd
Ste 200
Indianapolis, IN 46256

Interoperability endpoints

  • Direct secure messaging: tdivens7727@direct.franciscanalliance.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608768000000",
    "number": "1164416475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9998 CROSSPOINT BLVD",
            "address_2": "STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462563307",
            "telephone_number": "317-579-2150",
            "fax_number": "317-579-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9998 CROSSPOINT BLVD STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462563307",
            "telephone_number": "317-579-2150",
            "fax_number": "317-579-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVENS",
        "first_name": "TIMOTHY",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2020-12-24",
        "certification_date": "2020-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "1050545",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01050545A",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IN",
            "license": "01050545A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000204809",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300138597",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00024122",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00024421",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00346514",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00023584",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00023634",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00024260",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00023583",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00024059",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00024079",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00024419",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300124562",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20025310A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00023585",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P000233634",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00023582",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.