NPIMap

Individual provider Active NPI

Gina M Divenuti, MD

  • Hematology & Oncology Physician
  • Concord, NH
National Provider Identifier
1912958703
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
11904 Issued in NH
Practice address
250 Pleasant St
Concord, NH 03301-7559
Phone
(603) 622-6484
Fax
(603) 622-7438
NPI assigned
May 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 11904 NH Primary

Addresses

Primary practice location

250 Pleasant St
Concord, NH 03301-7559

Mailing address

11 Kimball Dr Unit 125
Hooksett, NH 03106-2623
Phone (603) 622-6484

Other identifiers 1

IdentifierTypeStateIssuer
30203690MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20050328000241 NH Practitioner - Medical OncologyPractitioner - Internal MedicinePractitioner - HematologyPractitioner - Hematology/Oncology 3173579778 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Hematology, Internal Medicine
Education
Warren Alpert Medical School of Brown University, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elliot Professional ServicesGroup PAC ID 6103727920, 429 clinicians
New Hampshire Oncology-Hematology PAGroup PAC ID 0143290759, 14 clinicians

Practice addresses (Care Compare)

1 Elliot Way
Manchester, NH 03103-3502
Phone (603) 622-6484

250 Pleasant St
Concord, NH 03301-7559
Phone (603) 224-2556

One Elliot Way
100 Elliot Cardiovascular Consultants
Manchester, NH 03103-3502
Phone (603) 627-1669

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Professional Services CurrentSince Aug 3, 2020 Accepting new patients
Lrghealthcare Hematology & Oncology CurrentSince Apr 1, 2017 Accepting new patients
New Hampshire Oncology-Hematology PA Hematology & Oncology CurrentSince Aug 1, 2003 Accepting new patients
Exeter Health Resources Inc Past Accepting new patients

Locations

250 Pleasant St
Concord, NH 03301
Phone (603) 225-2711

250 Pleasant St
Fl 2
Concord, NH 03301
Phone (603) 622-6484

14 Maple St
Slp Evaluation
Gilford, NH 03249
Phone (603) 737-6755

11 Kimball Dr
Unit 125
Hooksett, NH 03106
Phone (603) 314-6879

200 Technology Dr
Hooksett, NH 03106
Phone (603) 622-6484

80 Highland St
Laconia, NH 03246
Phone (603) 527-7100

40 Buttrick Rd
Londonderry, NH 03053
Phone (603) 552-1400

1 Elliot Way
Ste 200
Manchester, NH 03103
Phone (603) 623-4640

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

Organizations & group practices 4

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 8

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1912958703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 KIMBALL DR UNIT 125",
            "city": "HOOKSETT",
            "state": "NH",
            "postal_code": "031062623",
            "telephone_number": "603-622-6484",
            "fax_number": "603-622-7438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PLEASANT ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033017559",
            "telephone_number": "603-622-6484",
            "fax_number": "603-622-7438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVENUTI",
        "first_name": "GINA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NH",
            "license": "11904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30203690",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NH

Sources for this page

Verify at the official NPI Registry.