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DHIVYA T PATTANIYIL MSN, CRNP
NPI 1063983419
Nurse Practitioner - Family in Philadelphia, PA

Active since December 11, 2018PECOS EnrolledAccepts Medicare Assignment
4417 N 6TH ST, PHILADELPHIA, PA 19140(215) 302-3600(215) 329-2369 Get Directions Write a Review

NPPES record last updated: May 6, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 6, 2025, Jul 15, 2023, Dec 11, 2018 (3 updates tracked since 2018).

About Dhivya T Pattaniyil Msn, Crnp NPPES

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

DHIVYA T PATTANIYIL MSN, CRNP (NPI 1063983419) is an individual family provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (SP019758) and active in the NPI registry since December 2018. She is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1063983419
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameDHIVYA T PATTANIYILCredential: MSN, CRNP
Location Address4417 N 6TH STPhiladelphia, PA 19140-2319
Mailing Address8118 Old York Rd Ste DElkins Park, PA 19027-1423
Phone(215) 302-3600
Fax(215) 329-2369
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateDecember 11, 2018
Last NPPES UpdateMay 6, 20253 updates tracked since enumeration
NPPES CertifiedMay 6, 2025
✔ NPI 1063983419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in PA · SP019758
4417 N 6TH ST, Philadelphia, PA 19140
Open in Google Maps ↗

Secondary Practice Locations 3

Location 12940 N 5th StPhiladelphia, PA 19133-2801 · Phone (215) 302-3600 · Fax (215) 329-2369
Location 2861 E Allegheny AvePhiladelphia, PA 19134-2401 · Phone (215) 302-3600 · Fax (215) 329-2369
Location 34201 Henry AvePhiladelphia, PA 19144-5409 · Phone (215) 951-2086 · Fax (215) 951-6867

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

Dhivya T Pattaniyil Msn, Crnp 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 ID8921514456
PECOS Enrollment IDI20250722002573
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19140 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
$92.69 typical visit price
range $59.88 – $180.99
Typical copayment $23.17 (range $14.97 – $45.24)
Most-billed visit code 99203
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

DOMINIC DERENGE D.O.
Family Medicine
4417 N 6TH ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 302-6000
HELEN MUTOKO
Nurse Practitioner (Family)
4417 N 6TH ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 302-3600
MARY SIMMS LPC
Counselor (Mental Health)
4417 N 6TH ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 302-3600
OANH HOANG VO CRNP
Nurse Practitioner (Family)
4417 N 6TH ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 302-3600
KERITH DUGGAN CRNP
Nurse Practitioner (Pediatrics)
4417 N 6TH ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 302-3600
ESPERANZA HEALTH CENTER, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
4417 N 6TH ST, ESPERANZA HEALTH CEN
PHILADELPHIA, PA 19140
Philadelphia County (215) 302-3150
CHRISTINA ELYSE DERENGE PSYD
Psychologist
4417 N 6TH ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 302-3600
LAURA CLAIRE CHACON
Doula
4417 N 6TH ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 302-3600

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 Dhivya Pattaniyil's NPI number?

The NPI number for Dhivya Pattaniyil is 1063983419. It was assigned to this individual provider in the NPPES registry on December 11, 2018.

Where is Dhivya Pattaniyil located?

Dhivya Pattaniyil practices at 4417 N 6th St, Philadelphia, PA 19140. The listed phone number is (215) 302-3600.

What is Dhivya Pattaniyil's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Dhivya Pattaniyil enrolled in Medicare?

Yes. Dhivya Pattaniyil 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.

When was this NPI record last updated?

The NPPES record for Dhivya Pattaniyil was last updated on May 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.