MR. ALAN DIVINE (M.D.) – Internal Medicine Physician, NPI 1104825280

MR. ALAN DIVINE (M.D.) is a healthcare provider. based in Minneapolis, Minnesota. specializing in INTERNAL MEDICINE. They hold the professional credentials M.D.. They hold a License No. 26378 (MN). The NPI Number for MR. ALAN DIVINE (M.D.) is 1104825280

Main info

Male
46 Years Of Experience
Accepts Medicare Assignment
Name
MR. ALAN DIVINE (M.D.)
NPI
1104825280
Phone
(612) 339-7171
Address
825 S 8TH ST
Enumeration Date
20 July 2005
Last Update Date
10 November 2020

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
3206825225
Graduation Year
1980 (46 years ago)
PAC ID
9032004734
Group Practice PAC ID
4587573613
Professional Enrollment ID
I20040220000593
Address ID
MN553021109AN440XXEXXX400
Telehealth
Yes

Contacts

Secure Messaging
adivine84172@excellian.direct.allina.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

3,636 INTERNAL MEDICINE in MN

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Provider Addresses for MR. ALAN DIVINE (M.D.)

  • South 8th Street, Phillips, Minneapolis, Hennepin County, Minnesota, 55415-1226, United States

    PARKSIDE PROFESSIONAL BLDG., STE 600

    MINNEAPOLIS, MN 554041208

    Phone: (612) 339-7171

    Fax: (612) 339-2885

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2004-02-20

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040220000593IInternal MedicineMNTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes882427$0
36415Insertion of needle into vein for collection of blood sample856405$0
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count575358$0
93793Anticoagulant management of patient taking warfarin34222$0
80053Blood test, comprehensive group of blood chemicals340300$0
View full utilization report →

Insurance plans in this area (ZIP 55404)

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Provider's Procedures

MR. ALAN DIVINE (M.D.) performs procedures in INTERNAL MEDICINE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEMN83036Hemoglobin A1C level10971

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4587573613View full group profile

Reviews

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Frequently asked questions

How is MR. ALAN DIVINE (M.D.) identified in CMS data?
CMS-hosted NPPES data lists MR. ALAN DIVINE (M.D.) with NPI 1104825280.
Does the file indicate MR. ALAN DIVINE (M.D.) is practicing under active NPI?
Directory data currently reports MR. ALAN DIVINE (M.D.) as active.
What is MR. ALAN DIVINE (M.D.)'s primary classification?
Internal Medicine Physician is the headline specialty for MR. ALAN DIVINE (M.D.) here. Clinical services aligned with this taxonomy classification.
What address line appears for MR. ALAN DIVINE (M.D.)?
MR. ALAN DIVINE (M.D.)'s geographic hint is Minneapolis, Minnesota in our summary view.
Is the information about MR. ALAN DIVINE (M.D.) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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