Divya Rebecca Roberts, CRNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

APRN-3612 Issued in HI

Practice address

55 Merchant St Ste 2900
Honolulu, HI 96813-4384

Phone

(808) 536-8012

Fax

(808) 536-8013

NPI assigned

Feb 21, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Bristol Palliative Care Services, LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Salt Lake City, UT
  • NPI 1467930552

  HI

  Medicare reassignment

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

{
    "created_epoch": "1550707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1235696741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2191 LAUKAHI ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968212619",
            "telephone_number": "716-200-9457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MERCHANT ST STE 2900",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968134384",
            "telephone_number": "808-536-8012",
            "fax_number": "808-536-8013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "DIVYA",
        "middle_name": "REBECCA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-21",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "HI",
            "license": "APRN-3612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert L. Peterson, Inc.
• Robert Nye, M.D., LLC
• Roberto'S Group Inc.
• Destiny-Jade Kimiko Roberts-Wada
• Celene Sue Roberts, MSW
• Dorcas S. Roberts, PSY.D
• Ellen Roberts, MSCP, LMFT
• Lauren Roberts
• Lauren Victoria Roberts
• Maria Roberts

• Gerontology Nurse Practitioner in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Gerontology Nurse Practitioner in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.