Divya T Raviendran, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A81826 Issued in CA

Practice address

3151 Crow Canyon PL
San Ramon, CA 94583-1359

Phone

(888) 663-6331

NPI assigned

Jun 27, 2006

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

Other identifiers 1

Other names 1

• Divya Raj Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Family Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

One Medical Group IncGroup PAC ID 2567623739, 330 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• John Muir Medical Center - Walnut Creek Campus Hospital, Walnut Creek, CA, CCN 050180

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Axis Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Livermore, CA
  • NPI 1336990506

  Corporate Director

  CMS ownership
• Axis Community Health Inc

  • Community Health Clinic/Center
  • Pleasanton, CA
  • NPI 1609249994

  Corporate Director

  CMS ownership

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.

• One Medical Group, Inc.

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1467781641
  Medicare reassignment Care Compare group NPD
• One Medical Group, Inc

  • Family Medicine Physician
  • Tigard, OR
  • NPI 1891521134
  NPD
• University of California San Francisco

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Francisco, CA
  • NPI 1992818256
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• John Muir Health

  • General Acute Care Hospital
  • Walnut Creek, CA
  • NPI 1740215219
  Care Compare affiliation

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1639106610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 CROW CANYON PL",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831359",
            "telephone_number": "888-663-6331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3850 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "94610",
            "country_code": "US",
            "telephone_number": "510-225-1013",
            "fax_number": "510-225-1019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4050 Dublin Blvd",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "CA",
            "postal_code": "945683112",
            "country_code": "US",
            "telephone_number": "925-875-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4050 Dublin Blvd",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "CA",
            "postal_code": "945683112",
            "country_code": "US",
            "telephone_number": "925-875-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAVIENDRAN",
        "first_name": "DIVYA",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A81826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M.D LICENSE",
            "identifier": "A81826",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIVYA",
            "last_name": "RAJ",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rashpal Deol DDS Inc
• Jay Rathod
• Kaelani Ratliff
• Kate Elise Ratto, PNP
• Aniket R Raval
• Kayla Ray
• Karla Andrea Rayas Gallardo
• Susan Raymond, MD
• Gisselle M Raymundo
• Elia Diane Recinos

• Family Medicine Physician in San Ramon, CA
• Providers in San Ramon, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.