TATYANA DIVINO (DO) – Family Medicine Physician, NPI 1780812099
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
822 FAMILY PRACTICE in CT
Provider Addresses for TATYANA DIVINO (DO)
14 Jones Hollow Rd
ProHealth Physicians
Marlborough, CT 064471448
Phone: (860) 295-8217
Fax: (860) 295-9734
Type: Location
34 PROFFESSIONAL PARK RD
STORRS, CT 062681659
Phone: (860) 487-0002
Fax: (860) 429-1663
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $21.
Total Amount is formed as General ($21) + Research ($0) + Ownership ($0) = $21.
Last reported payment date: 2023-06-15 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($21).
Total Amount
$21
General + Research + Ownership
Payments
1
Total payment records
General Amount
$21
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-06-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $21 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2013-10-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20131017000954 | I | Family Practice | CT | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 204 | 103 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 44 | 44 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 39 | 31 | $0 |
| G0008 | Administration of influenza virus vaccine | 27 | 25 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 24 | 24 | $0 |
Insurance plans in this area (ZIP 06447)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | CT | |
| - | CT | |
| - | MA | |
| - | CT | |
| Internal Medicine | IL | |
| - | CT | |
| - | CT | |
| Nurse Practitioner | CT | |
| - | CT | |
| Internal Medicine | CT |
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