Individual provider Active NPI

Divya Ravi, MD

  • Internal Medicine Physician
  • Stockton, CA
National Provider Identifier
1851823181
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A166517 Issued in CA
Practice address
525 W Acacia St
Stockton, CA 95203-2405
Phone
(209) 461-7580
NPI assigned
Mar 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X A166517 CA Primary

Addresses

Primary practice location

525 W Acacia St
Stockton, CA 95203-2405

Mailing address

525 W Acacia St
Stockton, CA 95203-2405
Phone (209) 461-7580

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200714002183 CA Practitioner - Internal Medicine 9133499528 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient Specialists of California PCGroup PAC ID 3476864448, 373 clinicians

Practice addresses (Care Compare)

525 W Acacia St
Stockton, CA 95203-2405
Phone (209) 944-5550

Hospital & facility affiliations

  • St Joseph'S Medical Center of Stockton Hospital, Stockton, CA, CCN 050084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Specialists of California, PC Internal Medicine CurrentSince Oct 15, 2022 Accepting new patients
Hospitalist Medicine Physicians of California, Inc Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients

Locations

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

2615 Chester Ave
Bakersfield, CA 93301
Phone (661) 381-7545

800 E Washington Blvd
Crescent City, CA 95531
Phone (707) 464-8511

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

1081 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-0616

1000 Greenley Rd
Sonora, CA 95370
Phone (209) 263-0803

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

525 W Acacia St
Stockton, CA 95203
Phone (209) 944-5410

Organizations & group practices 2

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 1

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": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1851823181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 W ACACIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952032405",
            "telephone_number": "209-461-7580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W ACACIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952032405",
            "telephone_number": "209-461-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVI",
        "first_name": "DIVYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-28",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A166517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.