Venu Divi, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

C55612 Issued in CA

Practice address

350 W 5TH St Ste 209
San Pedro, CA 90731-2752

Phone

(310) 521-6386

Fax

(310) 521-6387

NPI assigned

Dec 11, 2006

Last updated

Jun 13, 2019By the provider in NPPES

Sex

Male

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 CA

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

Specialty

Otolaryngology

Education

Northeastern Ohio University College of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prohealth Partners, a Medical GroupGroup PAC ID 2769388412, 236 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Little Co of Mary Med Ctr San Pedro Hospital, San Pedro, CA, CCN 050078
• Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351
• Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Prohealth Partners, a Medical Group

  • Internal Medicine Physician
  • Lakewood, CA
  • NPI 1003949975
  Medicare reassignment Care Compare group NPD
• Beach Cities Ents

  • Otolaryngology Physician
  • Torrance, CA
  • NPI 1356612048
  Medicare reassignment
• Prohealth Partners a Medical Group Inc

  • Hospitalist Physician
  • Long Beach, CA
  • NPI 1104215151
  NPD
• Prohealth Partners, a Medical Group, Inc.

  • Internal Medicine Physician
  • Pico Rivera, CA
  • NPI 1912899394
  NPD
• Brett a. Levine, M.D., PC.

  • Otolaryngology Physician
  • Torrance, CA
  • NPI 1003015744
  NPD (past)
• Prohealth Partners, a Medical Group, Inc.

  • Internal Medicine Physician
  • Long Beach, CA
  • NPI 1639126279
  NPD (past)
• Providence Health System - Southern California

  • Psychiatric Hospital Unit
  • San Pedro, CA
  • NPI 1154349371
  NPD (past)
• Providence Health System Southern California

  dba Providence Little Company of Mary Medical Center Torrance

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1902844988
  NPD (past)
• Torrance Memorial Medical Center

  • Skilled Nursing Facility
  • Torrance, CA
  • NPI 1740268713
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health System - Southern California

  dba Providence Little Company of Mary Medical Center San Pedro OBHC

  • General Acute Care Hospital
  • San Pedro, CA
  • NPI 1497241541
  Care Compare affiliation
• Providence Health System - Southern California

  dba Providence Little Company of Mary Medical Center San Pedro

  • General Acute Care Hospital
  • San Pedro, CA
  • NPI 1942247291
  Care Compare affiliation
• Providence Health System Southern California

  dba Providence Little Company of Mary Medical Center Torrance

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1902844988
  Care Compare affiliation
• Torrance Memorial Medical Center

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1467459776
  Care Compare affiliation

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1245390228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21320 HAWTHORNE BLVD",
            "address_2": "SUITE 119",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905035606",
            "telephone_number": "310-540-2111",
            "fax_number": "310-944-9295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W 5TH ST STE 209",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312752",
            "telephone_number": "310-521-6386",
            "fax_number": "310-521-6387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3816 Woodruff Ave Ste 412",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908082146",
            "country_code": "US",
            "telephone_number": "310-521-6386",
            "fax_number": "310-521-6387",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21320 Hawthorne Blvd",
            "address_2": "Suite 119",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905035606",
            "country_code": "US",
            "telephone_number": "310-540-2111",
            "fax_number": "310-944-9295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIVI",
        "first_name": "VENU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "C55612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Diaz
• Marco Antonio Diaz, M.D.
• Robin Linda Dieda, L.C.S.W.
• Ivy Adao Diosa
• Adam Dishkin
• Lamont Edward Dobbins Jr.
• Dodson Psychological Services
• Faviola Don Juan, LVN
• Denise Donahue, P.A.
• Breanna Donatien

• Otolaryngology Physician in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.