Individual provider Active NPI

Divya Balasubramanian, D.O.

  • Emergency Medicine Physician
  • Buffalo, NY
National Provider Identifier
1437410131
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
Q6146 Issued in TX
Practice address
100 High St
Buffalo, NY 14203-1126
Phone
(716) 859-1499
NPI assigned
May 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Q6146 TX Primary

Addresses

Primary practice location

100 High St
Buffalo, NY 14203-1126

Mailing address

4835 LBJ Fwy Ste 900
Dallas, TX 75244-6001
Phone (469) 420-5544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151216002460 TX Practitioner - Emergency Medicine 7719288729 Reassigns benefits to 1 organization
I20231214002740 CA Practitioner - Emergency Medicine 7719288729 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of North Texas HSC, College of Osteopathic Med, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Santa ClaraGroup PAC ID 1254244973, 1,000 clinicians

Practice addresses (Care Compare)

1991 McKee Rd
San Jose, CA 95116-1406
Phone (408) 885-7366

1993 McKee Rd
San Jose, CA 95116-1406
Phone (408) 885-5000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Century Integrated Partners, Inc Emergency Medicine CurrentSince Mar 18, 2018 Accepting new patients
County of Santa Clara CurrentSince May 1, 2025 Accepting new patients
Permanente Medical Group Inc Emergency Medicine Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Oct 29, 2023 Accepting new patients
Permanente Medical Group Inc Emergency Medicine CurrentSince Oct 29, 2023 Accepting new patients
County of Santa Clara CurrentSince May 1, 2025 Accepting new patients
County of Santa Clara Current Accepting new patients

Locations (25 of 27)

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

1800 Harrison St
Fl 7
Oakland, CA 94612

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

250 Hospital Pkwy
San Jose, CA 95119
Phone (408) 972-6320

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

4835 Lyndon B Johnson Fwy
Ste 900
Dallas, TX 75244
Phone (469) 340-1366

3500 Gaston Ave
Dallas, TX 75246

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

Interoperability endpoints

  • Direct secure messaging: dbalasubramanian209551@santaclaravalley.direct-ci.net

Organizations & group practices 7

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": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1437410131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4835 LBJ FWY STE 900",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752446001",
            "telephone_number": "469-420-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031126",
            "telephone_number": "716-859-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALASUBRAMANIAN",
        "first_name": "DIVYA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-30",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q6146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.