Individual provider Active NPI

Divya Sahore, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1427681113
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
136 Harrison Ave Ste 207
Boston, MA 02111-1817
Phone
(617) 636-0405
NPI assigned
Feb 20, 2020
Last updated
Feb 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

136 Harrison Ave Ste 207
Boston, MA 02111-1817

Mailing address

96 Summer St
Medford, MA 02155-4434
Phone (781) 775-4902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20200417002701 MA Practitioner - Physician Assistant 1355771130 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Tufts University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

15 Railroad Ave
South Hamilton, MA 01982-2218
Phone (978) 468-7381

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Medical Group, Inc CurrentSince Apr 15, 2020 Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. CurrentSince Sep 22, 2025 Accepting new patients
Beth Israel Lahey Health Primary Care Inc CurrentSince Sep 22, 2025 Accepting new patients

Locations

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

Interoperability endpoints

  • Direct secure messaging: dsahore132969@direct.bilh.masshiway.net
  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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 2

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": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1427681113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 SUMMER ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554434",
            "telephone_number": "781-775-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 HARRISON AVE STE 207",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111817",
            "telephone_number": "617-636-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAHORE",
        "first_name": "DIVYA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.