DIVYA GOUTAM VIJENDRA (M.D.) – Medical Oncology Physician, NPI 1164502373
Medical Oncology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
599 HEMATOLOGY/ONCOLOGY in OH
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Provider Addresses for DIVYA GOUTAM VIJENDRA (M.D.)
Bryan Hospital, 433, West High Street, Bryan Downtown Historic District, Bryan, Pulaski, Williams County, Ohio, 43506, United States
BRYAN, OH 435061690
Phone: (419) 636-1131
Fax: (419) 636-3100
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)
CMS reports 7 Open Payments records for all available years, with a total value of $139.
Total Amount is formed as General ($139) + Research ($0) + Ownership ($0) = $139.
Last reported payment date: 2024-11-21 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($38).
Total Amount
$139
General + Research + Ownership
Payments
7
Total payment records
General Amount
$139
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-21
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2004-09-18
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 |
|---|---|---|---|---|
| I20040918000136 | I | Hematology/Oncology | OH | 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 | 135 | 60 | $0 |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 22 | 22 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 20 | 17 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 43506)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OH | |
| P A T H O L O G Y | OH | |
| General Surgery, Critical Care (Intensivists) | MI | |
| - | OH | |
| Nurse Practitioner | OH | |
| - | OH | |
| - | OH | |
| General Surgery | ME | |
| Vascular Surgery, General Surgery | MN | |
| - | OH |
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