Tiera Divers

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

350091 Issued in NY

Practice address

221 Ernst St
Rochester, NY 14621-3829

Phone

(585) 505-1959

NPI assigned

Oct 23, 2025

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1761177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1508733544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 ERNST ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 ERNST ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213829",
            "telephone_number": "585-505-1959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVERS",
        "first_name": "TIERA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-23",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "350091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wimal Samarasinghe Dissanayake, MD
• Wendy Distasio
• Allison G Distefano, MS
• Paul Distefano, MS
• Joseph Anthony Ditursi, MD
• Diverse Mosaic Community Center Inc
• Diversified Dental Service
• Caitlyn Divincenzo, NP
• Berana Divine, RRT
• Michael Vincent Divito, RPAC

• Licensed Practical Nurse in Rochester, NY
• Providers in Rochester, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.