Individual provider Active NPI

Divya Pana Shenoy, M.D.

  • Family Medicine Physician
  • Washington, DC
National Provider Identifier
1215322797
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD210002783 Issued in DC
Practice address
1225 4TH St NE
Washington, DC 20002-3431
Phone
(202) 347-8500
NPI assigned
Apr 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0095907 MD
Family Medicine Physician 207Q00000X 0101277413 VA
Family Medicine Physician 207Q00000X MD210002783 DC Primary

Addresses

Primary practice location

1225 4TH St NE
Washington, DC 20002-3431

Mailing address

1225 4TH St NE
Washington, DC 20002-3431

Other practice location 1

19650 Club House Rd # 101
Gaithersburg, MD 20886-3003
Phone (202) 347-8512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD210002783DCMDFamily Medicine Physician
D0095907MDMDFamily Medicine Physician
0101277413VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of Metropolitan Washington DC PastSince Mar 24, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Planned Parenthood of Metropolitan Washington DC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1215322797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 4TH ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200023431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 4TH ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200023431",
            "telephone_number": "202-347-8500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19650 Club House Rd # 101",
            "address_purpose": "LOCATION",
            "city": "Gaithersburg",
            "state": "MD",
            "postal_code": "208863003",
            "country_code": "US",
            "telephone_number": "202-347-8512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHENOY",
        "first_name": "DIVYA",
        "middle_name": "PANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0095907",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101277413",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD210002783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.