Divine F. Ticha

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R197963 Issued in MD

Practice address

1818 New York Ave NE
117 Global Healthcare
Washington, DC 20002

Phone

(202) 480-0813

Fax

(202) 503-2363

NPI assigned

Apr 30, 2012

Sex

Male

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 DC, MD2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychogeriatric Services LLCGroup PAC ID 6002719226, 122 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Alidi Behavioral & Integrated Healthcare Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Takoma Park, MD
  • NPI 1336937044

  DC

  Medicare reassignment NPD Authorized official
• Psychogeriatric Services LLC

  • Psychiatry Physician
  • Columbia, MD
  • NPI 1588689483

  DC

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1750649554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13994 BALTIMORE AVENUE",
            "address_2": "13994 BALTIMORE AVENUE SUITE 102",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20707",
            "telephone_number": "240-491-2868",
            "fax_number": "301-477-1758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 NEW YORK AVE NE",
            "address_2": "117 GLOBAL HEALTHCARE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20002",
            "telephone_number": "202-480-0813",
            "fax_number": "202-503-2363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICHA",
        "first_name": "DIVINE",
        "middle_name": "F.",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-30",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R197963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camilla Tibbetts
• Paul Andrew Tibbits, M.D.
• Mattie Tibbs
• Chanceline Ngehbenwi Tibui
• Ashley Nicole Tice, AU.D.
• Judith Yeager Tiddy, NP
• Lauren D Tidwell
• Eucheria Tiebia
• Lindsay H Tiell, MSW, LICSW, LCSW-C
• Brett Phillip Tielman-Fenelus

• Psychiatric/Mental Health Nurse Practitioner in Washington, DC
• Providers in Washington, DC by specialty
• Psychiatric/Mental Health Nurse Practitioner in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.