Individual provider Active NPI

Divya Kulshreshtha, FNP

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1861842585
Registry record updated Nov 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F341675-1 Issued in NY
Practice address
130 Lenox Ave
New York, NY 10026
Phone
(212) 348-2199
NPI assigned
Jun 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 22 694439 NY
Family Nurse Practitioner 363LF0000X F341675-1 NY Primary

Addresses

Primary practice location

130 Lenox Ave
New York, NY 10026

Mailing address

130 Lenox Ave
New York, NY 10026-2503

Other practice location 1

580 Broadway
Suite 608
New York, NY 10012
Phone (240) 643-5069

Other practice location 2

130 Malcolm X Blvd
New York, NY 10026
Phone (212) 348-2199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230711003759 NJ Practitioner - Nurse Practitioner 9739441759 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22 694439NYMDRegistered Nurse
F341675-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates of New Jersey, LLC CurrentSince Feb 25, 2023 Accepting new patients
Beeper Medical Group PC Past Accepting new patients

Locations

116 Village Blvd
Ste 200
Princeton, NJ 08540
Phone (609) 285-3094

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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.

NPI Registry JSON

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541462400000",
    "number": "1861842585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 LENOX AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100262503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 LENOX AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10026",
            "telephone_number": "212-348-2199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "580 Broadway",
            "address_2": "Suite 608",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10012",
            "country_code": "US",
            "telephone_number": "240-643-5069",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 Malcolm X Blvd",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10026",
            "country_code": "US",
            "telephone_number": "212-348-2199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KULSHRESHTHA",
        "first_name": "DIVYA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-14",
        "last_updated": "2018-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "22 694439",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F341675-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.