Individual provider Active NPI

Divya Gunda, MD

  • Diagnostic Radiology Physician
  • Camden, NJ
National Provider Identifier
1407016587
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
25MA11218300 Issued in NJ
Practice address
1 Cooper PLZ
Camden, NJ 08103-1461
Phone
(856) 342-2390
NPI assigned
Jun 12, 2008
Last updated
Sep 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 26490 OK
Diagnostic Radiology Physician 2085R0202X 25MA11218300 NJ Primary

Addresses

Primary practice location

1 Cooper PLZ
Camden, NJ 08103-1461

Mailing address

1 Federal St # 200
Camden, NJ 08103-1088
Phone (856) 356-4924

Other practice location 1

940 NE 13th St
4G4250
Oklahoma City, OK 73104-5008
Phone (405) 271-5125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20210914002245 NJ Practitioner - Diagnostic Radiology 6305064791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Oklahoma College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cooper University Radiology PCGroup PAC ID 6305838764, 68 clinicians

Practice addresses (Care Compare)

3 Cooper PLZ
Camden, NJ 08103-1438
Phone (853) 342-3300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.63 of 100Reported as group
Quality
80.63
Promoting interoperability
99
Improvement activities
40
Cost
40.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26490OKMDNeuroradiology Physician
25MA11218300NJMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper University Radiology, PC Neuroradiology CurrentSince Sep 1, 2021 Accepting new patients

Locations

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

2 Cooper Plz
Camden, NJ 08103
Phone (609) 342-7600

2 Cooper Plz
#400
Camden, NJ 08103
Phone (856) 342-2380

3 Cooper Plz
Camden, NJ 08103
Phone (609) 342-2001

3 Cooper Plz
Rm 100
Camden, NJ 08103
Phone (856) 342-8529

1103 Kings Hwy N
Cherry Hill, NJ 08034
Phone (609) 321-1800

400 W Route 38
Moorestown, NJ 08057
Phone (856) 270-4000

900 Centennial Blvd
Voorhees, NJ 08043
Phone (856) 325-6505

900 Centennial Blvd
Ste B
Voorhees, NJ 08043
Phone (856) 325-6580

Organizations & group practices 1

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": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1407016587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "856-342-2390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "940 NE 13th St",
            "address_2": "4G4250",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731045008",
            "country_code": "US",
            "telephone_number": "405-271-5125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUNDA",
        "first_name": "DIVYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-12",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "OK",
            "license": "26490",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA11218300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.