NPIMap

Individual provider Active NPI

Divya R Kini, MD

  • Family Medicine Physician
  • Daly City, CA
National Provider Identifier
1649354309
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A74472 Issued in CA
Practice address
1500 Southgate Ave
Suite 204
Daly City, CA 94015
Phone
(650) 755-2192
Fax
(650) 745-0710
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A74472 CA Primary

Addresses

Primary practice location

1500 Southgate Ave
Suite 204
Daly City, CA 94015

Mailing address

1500 Southgate Ave
Suite 204
Daly City, CA 94015
Phone (650) 755-2192

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070626000538 CA Practitioner - Family Practice 0143329532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1800 Sullivan Ave
Daly City, CA 94015-2224
Phone (650) 755-2192

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
31.87 of 100Reported as individual
Quality
20
Improvement activities
0
Cost
79.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A74472CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Divya R Kini MD Inc Family Medicine CurrentSince Apr 1, 2007 Accepting new patients
Kamal E Shamash MD Inc Family Medicine Past Accepting new patients
Palo Alto Medical Foundation Past Accepting new patients

Locations

1500 Southgate Ave
Ste 204
Daly City, CA 94015
Phone (650) 755-2192

1800 Sullivan Ave
Rm 407
Daly City, CA 94015
Phone (650) 636-4462

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1649354309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 SOUTHGATE AVE",
            "address_2": "SUITE 204",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "94015",
            "telephone_number": "650-755-2192",
            "fax_number": "650-745-0710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SOUTHGATE AVE",
            "address_2": "SUITE 204",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "94015",
            "telephone_number": "650-755-2192",
            "fax_number": "650-745-0710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINI",
        "first_name": "DIVYA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A74472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

Verify at the official NPI Registry.