Amy D Divasta
M.D. | Pediatric Adolescent Medicine | Female
Amy D Divasta, M.D. is a Boston, Massachusetts based Pediatric doctor with medical specialization in
Pediatric Adolescent Medicine.
Current practice location of Amy D Divasta is
300 Longwood Ave, Boston, Massachusetts - 02115-5724. She can be contacted on phone at
617-355-7181.
Amy D Divasta is a sole proprietor of her business.
NPI number (Unique professional ID) for Amy D Divasta is
1891732970 which was assigned by NPPES on 31 May, 2006 and it was last updated on 13 Aug, 2007.
Amy D Divasta license number is
224617 for Pediatrics Adolescent Medicine (2080A0000X) in Massachusetts.
Amy D Divasta specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Amy D Divasta basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Amy D Divasta |
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| Credential : | M.D. |
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| Gender : | Female |
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Business Address:
Amy D Divasta address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 300 Longwood Ave
Boston, MA, 02115-5724
United States |
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| Phone Number : | 617-355-7181 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1891732970 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 31 May, 2006 |
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| Last Updated On : | 13 Aug, 2007 |
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Medicare Participation:
Amy D Divasta participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.
| Medicare PECOS ID : | 6507893922 |
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| Medicare Enrollment ID : | I20050718000712 |
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| Primary Specialty : | Pediatric Medicine |
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| Medical School : | Tufts University School Of Medicine |
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| Graduation Year : | 1999 |
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| Accepts Medicare? | Yes. Amy D Divasta accepts medicare insurance. |
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Group Practice Association:
Amy D Divasta is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Amy D Divasta is associated with along with the number of members in that group. She may also accept medicare indirectly via these group practices.
| Organisation Name : | Group Practice ID | No. of Members | Practice Address | Group Accepts Medicare |
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| Children's Hospital Pediatric Associates, Inc | 3476541830 | 231 | 300 Longwood Ave
Boston, MA - 021155724
Ph: 6173556000 | Yes |
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Amy D Divasta are as mentioned. Primary taxonomy code for Amy D Divasta, M.D. is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
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| 2080A0000X | Pediatrics Adolescent Medicine | Yes | 224617 | MA |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 300 Longwood Ave
Boston, MA, 02115-5724
United States |
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| Phone Number : | 617-355-7181 |
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Business Location:
Patients can refer following map for directions to
Amy D Divasta practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.