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Individual provider Active NPI

Cindy Luong Divito, CRNP

  • Gerontology Nurse Practitioner
  • York, PA
National Provider Identifier
1780283689
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP022688 Issued in PA
Practice address
30 Monument Rd Ste 1100
York, PA 17403-5024
Phone
(717) 851-2441
Fax
(717) 260-3322
NPI assigned
Oct 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Clinical Nurse Specialist 364SG0600X SP022688 PA
Gerontology Nurse Practitioner 363LG0600X SP022688 PA Primary

Addresses

Primary practice location

30 Monument Rd Ste 1100
York, PA 17403-5024

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20201027000086 PA Practitioner - Nurse Practitioner 1052731312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

1001 S George St
York, PA 17403-3676

1001 S George St 2ND Floor
Wellspan Pulmonary and Sleep Medicine
York, PA 17403-3676
Phone (717) 851-2465

25 Monument Rd
York, PA 17403-5073

2618 E Market St
Autumn House
York, PA 17403
Phone (717) 845-7214

30 Monument Rd
Suite 1100
York, PA 17403-5024
Phone (717) 812-2480

914 W Market St
Autumn House West
York, PA 17403
Phone (717) 845-7214

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP022688PAMDGerontology Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Dec 1, 2020 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince Dec 1, 2020 Accepting new patients

Locations

30 Monument Rd
Ste 1100
York, PA 17403
Phone (717) 851-2441

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

25 Monument Rd
Ste 100
York, PA 17403
Phone (717) 741-4785

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

Interoperability endpoints

  • Direct secure messaging: cdivito12962@wellspan.direct-ci.com

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1780283689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405",
            "fax_number": "717-851-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MONUMENT RD STE 1100",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174035024",
            "telephone_number": "717-851-2441",
            "fax_number": "717-260-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVITO",
        "first_name": "CINDY",
        "middle_name": "LUONG",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "PA",
            "license": "SP022688",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP022688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.