NINAH DIVINE MD
NPI 1174104590
Family Medicine in Milwaukee, WI

Active since April 16, 2021PECOS EnrolledAccepts Medicare Assignment
930 W HISTORIC MITCHELL ST, MILWAUKEE, WI 53204(414) 383-9526(414) 649-2711 Get Directions Write a Review

NPPES record last updated: July 21, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 9, 2025, Jun 26, 2024, Apr 16, 2021 (3 updates tracked since 2021).

About Ninah Divine Md NPPES

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

NINAH DIVINE MD (NPI 1174104590) is an individual family medicine provider in Milwaukee, Wisconsin, licensed in Wisconsin (84297-20) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and is a graduate of University Of Wisconsin School Of Medicine (2021).

NPPES Registry Identity

NPI1174104590
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameNINAH DIVINECredential: MD
Location Address930 W HISTORIC MITCHELL STMilwaukee, WI 53204-3533
Mailing Address930 W Historic Mitchell StMilwaukee, WI 53204-3533
Fax(414) 649-2711
Sole ProprietorNo
Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 2021
Enumeration DateApril 16, 2021
Last NPPES UpdateJuly 21, 20253 updates tracked since enumeration
NPPES CertifiedJuly 21, 2025
NPI 1174104590 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in WI · 84297-20
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

930 W HISTORIC MITCHELL ST, Milwaukee, WI 53204

Accepted 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

Ninah Divine Md 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 ID7719374727
PECOS Enrollment IDI20251014001588
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 53204 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

Dental Hygienist
930 W HISTORIC MITCHELL ST
MILWAUKEE, WI 53204
Clinic/Center (Federally Qualified Health Center (FQHC))
930 W HISTORIC MITCHELL ST
MILWAUKEE, WI 53204
Nurse Practitioner (Family)
930 W HISTORIC MITCHELL ST
MILWAUKEE, WI 53204
Obstetrics & Gynecology
930 W HISTORIC MITCHELL ST
MILWAUKEE, WI 53204
Counselor (Professional)
930 W HISTORIC MITCHELL ST
MILWAUKEE, WI 53204
Nurse Practitioner (Family)
930 W HISTORIC MITCHELL ST
MILWAUKEE, WI 53204
Physical Therapist
930 W HISTORIC MITCHELL ST
MILWAUKEE, WI 53204
Pharmacist
930 W HISTORIC MITCHELL ST
MILWAUKEE, WI 53204

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 Ninah Divine's NPI number?

The NPI number for Ninah Divine is 1174104590. It was assigned to this individual provider in the NPPES registry on April 16, 2021.

Where is Ninah Divine located?

Ninah Divine practices at 930 W Historic Mitchell St, Milwaukee, WI 53204. The listed phone number is (414) 383-9526.

What is Ninah Divine's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Ninah Divine enrolled in Medicare?

Yes. Ninah 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 Ninah Divine accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Network Health, Quartz and UnitedHealthcare list Ninah 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.

When was this NPI record last updated?

The NPPES record for Ninah Divine was last updated on July 21, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.