Individual provider Active NPI

Divya Sivakumar, D.O., M.A.

  • Neurology Physician
  • Lake Saint Louis, MO
National Provider Identifier
1528419587
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2021046762 Issued in MO
Practice address
2300 HRC Plaza Dr
Lake Saint Louis, MO 63367-2367
Phone
(636) 425-4673
NPI assigned
Jun 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2021046762 MO Primary

Addresses

Primary practice location

2300 HRC Plaza Dr
Lake Saint Louis, MO 63367-2367

Mailing address

2300 HRC Plaza Dr
Lake Saint Louis, MO 63367-2367
Phone (636) 425-4673

Other practice location 1

6500 Hospital Dr
Hannibal, MO 63401-6890
Phone (573) 629-3500

Other identifiers 1

IdentifierTypeStateIssuer
1528419587MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MO2 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
I20201012001549 WI Practitioner - Neurology 5092000851 Reassigns benefits to 1 organization
I20211210002430 MO Practitioner - Neurology 5092000851 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hope Headache and Neurology LLCGroup PAC ID 1456700202, 3 clinicians

Practice addresses (Care Compare)

2300 HRC Plaza Dr
Lake Saint Louis, MO 63367-2367
Phone (636) 425-4673

6500 Hospital Dr
Hannibal, MO 63401-6890
Phone (573) 248-1300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021046762MOMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Headache and Neurology LLC Neurology CurrentSince Nov 4, 2022 Accepting new patients
Hannibal Regional Healthcare System Inc CurrentSince Jan 6, 2025 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Sep 1, 2020 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jul 1, 2022 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jul 1, 2022 Accepting new patients
Hannibal Regional Healthcare System, Inc CurrentSince Jan 6, 2025 Accepting new patients

Locations

6000 Hospital Dr
Hannibal, MO 63401
Phone (573) 248-5460

6500 Hospital Dr
Hannibal, MO 63401
Phone (573) 629-3400

2300 Hrc Plaza Dr
Lake Saint Louis, MO 63367
Phone (636) 425-4673

621 S New Ballas Rd
Ste 6005B
Saint Louis, MO 63141
Phone (314) 251-6075

621 S New Ballas Rd
Ste 5003B
Saint Louis, MO 63141
Phone (314) 227-2020

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

3862 Mexico Rd
Saint Peters, MO 63303
Phone (636) 387-5100

1021 Wentzville Pkwy
Wentzville, MO 63385
Phone (636) 787-7685

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602
  • Direct secure messaging: divyasivakumar@hrmg.allscriptsdirect.net

Organizations & group practices 6

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.

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": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1528419587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HRC PLAZA DR",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633672367",
            "telephone_number": "636-425-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HRC PLAZA DR",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633672367",
            "telephone_number": "636-425-4673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6500 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Hannibal",
            "state": "MO",
            "postal_code": "634016890",
            "country_code": "US",
            "telephone_number": "573-629-3500",
            "fax_number": "573-629-3515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIVAKUMAR",
        "first_name": "DIVYA",
        "credential": "D.O., M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2021046762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528419587",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.