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MS. LILA T DIVINE PA
NPI 1043883093
Physician Assistant in Charlotte, NC

Active since July 19, 2021PECOS EnrolledAccepts Medicare Assignment
83.88/100
CMS Quality Rating
10905 PROVIDENCE RD W STE 270, CHARLOTTE, NC 28277(704) 316-3410(704) 316-3420 Get Directions Write a Review

NPPES record last updated: July 31, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 6, 2022, Nov 9, 2021, Jul 19, 2021 (3 updates tracked since 2021).

About Ms. Lila T Divine Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. LILA T DIVINE PA (NPI 1043883093) is an individual physician assistant in Charlotte, North Carolina, licensed in North Carolina (0010-14463) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS, is affiliated with Novant Health Matthews Medical Center, and maintains a secondary practice location in Laguna Woods.

NPPES Registry Identity

NPI1043883093
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMS. LILA T DIVINECredential: PA
Location Address10905 PROVIDENCE RD W STE 270Charlotte, NC 28277-1538
Mailing AddressPo Box 60447Charlotte, NC 28260-0447
Phone(704) 316-3410
Fax(704) 316-3420
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateJuly 19, 2021
Last NPPES UpdateJuly 31, 20253 updates tracked since enumeration
NPPES CertifiedJuly 31, 2025
✔ NPI 1043883093 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Licenses✔ Licensed in NC · 0010-14463✔ Licensed in CA · 60085
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
10905 PROVIDENCE RD W STE 270, Charlotte, NC 28277
Open in Google Maps ↗

Secondary Practice Location 1

Location 124331 El Toro Rd Ste 200Laguna Woods, CA 92637-3116 · Phone (949) 586-3200

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Lila T Divine Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9739578501
PECOS Enrollment IDI20250905002952
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Replacement of thigh bone and hip joint with prosthesis 27130
This procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.
16 services15 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Novant Health Matthews Medical Center

Acute Care Hospitals · Matthews, NC
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number340171
Location1500 Matthews Twnshp Prkwy Box 3310Matthews, NC 28106 · Mecklenburg County
Emergency services Birthing friendly

Novant Health Ballantyne Medical Center

Acute Care Hospitals · Charlotte, NC
OwnershipVoluntary non-profit - Private
CMS Certification Number340195
Location10905 Providence Road WCharlotte, NC 28277 · Mecklenburg County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28277 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.88/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality56.83
Improvement Activities40
Cost79.67

Reported Quality Measures

Documentation of Current Medications in the Medical Record
95%20 patients4/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
0%24 patients1/55-star benchmark: 97%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TAYLOR AMANDA TUTEN PA
Physician Assistant
10905 PROVIDENCE RD W STE 270
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-3410
MATTHEW WINFIELD BLACK PA-C
Physician Assistant
10905 PROVIDENCE RD W STE 270
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-3410
ADAM WAEL OMAR
Physician Assistant
10905 PROVIDENCE RD W STE 270
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-3410
ERIC JAMES CORLETT
Physician Assistant
10905 PROVIDENCE RD W STE 270
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-3410

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lila Divine's NPI number?

The NPI number for Lila Divine is 1043883093. It was assigned to this individual provider in the NPPES registry on July 19, 2021.

Where is Lila Divine located?

Lila Divine practices at 10905 Providence Rd W Ste 270, Charlotte, NC 28277. The listed phone number is (704) 316-3410.

What is Lila Divine's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Lila Divine enrolled in Medicare?

Yes. Lila Divine is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Lila Divine accept?

Health plans from Blue Cross and Blue Shield of NC list Lila Divine as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Lila Divine affiliated with any hospitals?

According to CMS data, Lila Divine is affiliated with Novant Health Matthews Medical Center and Novant Health Ballantyne Medical Center.

When was this NPI record last updated?

The NPPES record for Lila Divine was last updated on July 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.