Individual provider Active NPI

Divya Shravani Kaminedi, MD

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1164946661
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C1-0024682 Issued in DE
Practice address
1650 Grand Concourse
Bronx, NY 10457-7606
Phone
(646) 413-9607
NPI assigned
Jul 27, 2017
Last updated
Sep 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C1-0024682 DE Primary

Addresses

Primary practice location

1650 Grand Concourse
Bronx, NY 10457-7606

Mailing address

17071 Windward Blvd Unit 204
Milford, DE 19963-5018
Phone (317) 712-6754

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220909000872 DE Practitioner - HospitalistPractitioner - Internal Medicine 9638554728 Reassigns benefits to 1 organization
I20260126000287 NJ Practitioner - Internal Medicine 9638554728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apogee Medical Group Delaware IncGroup PAC ID 9638312572, 94 clinicians
NJ Acute Care Specialists Professional CorporationGroup PAC ID 3678742269, 55 clinicians

Practice addresses (Care Compare)

100 Wellness Way
Milford, DE 19963-4364
Phone (302) 430-5175

901 W Main St
Freehold, NJ 07728-2537
Phone (973) 831-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.66 of 100Reported as group
Quality
81.55
Improvement activities
40
Cost
75.84

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
NJ Acute Care Specialists Professional Corporation Internal Medicine CurrentSince Feb 1, 2026 Accepting new patients
Apogee Medical Group, Delaware, Inc Internal Medicine CurrentSince Jul 5, 2022 Accepting new patients
Bayhealth Medical Center, Inc. Past Accepting new patients

Locations

15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601

640 S State St
Dover, DE 19901
Phone (302) 744-4700

100 Wellness Way
Milford, DE 19963
Phone (302) 422-3311

901 W Main St
Freehold, NJ 07728
Phone (732) 294-2666

Organizations & group practices 3

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 3

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": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1164946661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17071 WINDWARD BLVD UNIT 204",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199635018",
            "telephone_number": "317-712-6754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577606",
            "telephone_number": "646-413-9607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMINEDI",
        "first_name": "DIVYA",
        "middle_name": "SHRAVANI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-27",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C1-0024682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.