LARA KATHLEEN DIVINS
NPI 1174881775
Physician Assistant in Tionesta, PA

Q: What is Lara Divins's NPI number?

The NPI number for Lara Divins is 1174881775. It was assigned to this individual provider in the NPPES registry on May 2, 2012. The provider is also known as Lara Kathleen Johnson.

Q: What is Lara Divins's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Lara Divins was last updated on May 31, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.

Active since May 02, 2012PECOS EnrolledAccepts Medicare Assignment

111 BRIDGE ST, TIONESTA, PA 16353(814) 755-3631(814) 755-3633 Get Directions Write a Review

NPPES record last updated: May 31, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 31, 2021, Nov 22, 2019, Apr 1, 2019 and 3 more (6 updates tracked since 2017).

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About Lara Kathleen Divins NPPES

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

LARA KATHLEEN DIVINS (NPI 1174881775) is an individual physician assistant in Tionesta, Pennsylvania and active in the NPI registry since May 2012. She is enrolled in Medicare PECOS, is affiliated with Titusville Area Hospital, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1174881775

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameLARA KATHLEEN DIVINS

Location Address111 BRIDGE STTionesta, PA 16353-9737

Mailing Address406 W Oak StTitusville, PA 16354-1404 · (814) 755-3631 · Fax (814) 755-3633

Phone(814) 755-3631

Fax(814) 755-3633

Sole ProprietorYes

Medical School CMSOtherGraduated 2017

Enumeration DateMay 2, 2012

Last NPPES UpdateMay 31, 20216 updates tracked since enumeration

NPPES CertifiedMay 31, 2021

✔ NPI 1174881775 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

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.

Also ListedSpecialist/Technologist · Athletic TrainerTaxonomy 2255A2300X

111 BRIDGE ST, Tionesta, PA 16353

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Other Names 1

Former Name (1)Lara Kathleen Johnson

Secondary Practice Locations 3

Location 1809 N Monroe StTitusville, PA 16354-1113 · Phone (814) 758-7676

Location 2115 Main StTidioute, PA 16351-1062 · Phone (814) 484-3096 · Fax (814) 484-3097

Location 3116 Central AveOil City, PA 16301-2736 · Phone (814) 676-0431 · Fax (814) 677-6343

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

Lara Kathleen Divins 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 ID6507138666

PECOS Enrollment IDI20170824000600

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 4

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

37 services20 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

23 services19 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

18 services18 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

13 services13 patients

Hospital Affiliations CMS Care Compare

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

Titusville Area Hospital

Critical Access Hospitals · Titusville, PA

OwnershipVoluntary non-profit - Private

CMS Certification Number391314

Location406 West Oak StreetTitusville, PA 16354 · Crawford County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 16353 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

$84.88 typical visit price

range $54.64 – $166.87

Typical copayment $21.22 (range $13.66 – $41.71)

Most-billed visit code 99203

Established Patient

$68.36 typical visit price

range $17.33 – $135.84

Typical copayment $17.09 (range $4.33 – $33.96)

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.

Other Providers at the Same Location NPPES 6

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

MARY T. PETERSON COTA/L

Occupational Therapy Assistant