Kathleen Ann Divincenzo, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4494A Issued in WY

Practice address

707 Sheridan Ave
Cody, WY 82414

Phone

(307) 578-2480

Fax

(307) 578-2492

NPI assigned

Jun 13, 2006

Last updated

Oct 5, 2020By the provider in NPPES

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 WY

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

Merit-based Incentive Payment System (MIPS)

Final score

80.79 of 100Reported as group

Quality

72.82

Promoting interoperability

100

Improvement activities

40

Cost

63.14

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• West Park Hospital District

  dba Cody Regional Health

  • Critical Access Hospital
  • Cody, WY
  • NPI 1558351536
  Medicare reassignment
• Cody Regional Health EMS

  • Land Ambulance
  • Cody, WY
  • NPI 1366432197
  NPD
• West Park Hospital District Long Term Care Center

  • Skilled Nursing Facility
  • Cody, WY
  • NPI 1467534081
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1477596989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 SHERIDAN AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "82414",
            "telephone_number": "307-578-2480",
            "fax_number": "307-578-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 SHERIDAN AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "82414",
            "telephone_number": "307-578-2480",
            "fax_number": "307-578-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVINCENZO",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WY",
            "license": "4494A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derrik Walton DDS & Darren J. Ruesch DDS, PC
• Jacob G Despain, O.D.
• Misty A Di Meglio
• Chelsea Dillahunty
• Leyla Dim, LPC
• Joshua Dobson
• Stephen Ward Dominick, MSW, LCSW
• Marchand Dondero
• Katie Marie Donham
• Jade N Dorale

• Internal Medicine Physician in Cody, WY
• Providers in Cody, WY by specialty
• Internal Medicine Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; 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.