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MRS. RENEE PATRICE DIVINE
NPI 1245028521
Nurse Practitioner - Psychiatric/Mental Health in Fairfield, CT

Active since April 28, 2025PECOS Enrolled
1073 N BENSON RD, FAIRFIELD, CT 06824(203) 254-4000 Get Directions Write a Review

NPPES record last updated: April 28, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mrs. Renee Patrice Divine NPPES

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

MRS. RENEE PATRICE DIVINE (NPI 1245028521) is an individual psychiatric/mental health provider in Fairfield, Connecticut, licensed in Connecticut (NA) and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1245028521
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameMRS. RENEE PATRICE DIVINE
Location Address1073 N BENSON RDFairfield, CT 06824-5195
Mailing Address95 Rockland AveStratford, CT 06614-3117 · (203) 241-6739
Phone(203) 254-4000
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateApril 28, 2025
NPPES CertifiedApril 28, 2025
✔ NPI 1245028521 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CT · NA
1073 N BENSON RD, Fairfield, CT 06824
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Renee Patrice Divine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1557866308
PECOS Enrollment IDI20250924000730
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 06824 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
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
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.

MAEGAN LILLIAN WILD
Social Worker (Clinical)
1073 N BENSON RD
FAIRFIELD, CT 06824
Greater Bridgeport Planning Region (203) 254-4000
BRENDAN OSLER
Counselor
1073 N BENSON RD
FAIRFIELD, CT 06824
Greater Bridgeport Planning Region (203) 254-4000
NATASHIA GREEN RN
Registered Nurse
1073 N BENSON RD
FAIRFIELD, CT 06824
Greater Bridgeport Planning Region (203) 254-4000
MACKENZIE GORDON RDN
Dietitian, Registered
1073 N BENSON RD
FAIRFIELD, CT 06824
Greater Bridgeport Planning Region (617) 721-1544
PETA-GAYE SIMMS CRNA
Nurse Anesthetist, Certified Registered
1073 N BENSON RD
FAIRFIELD, CT 06824
Greater Bridgeport Planning Region (347) 571-3579
KELLEY B SHANAHAN NP
Nurse Practitioner (Family)
1073 N BENSON RD
FAIRFIELD, CT 06824
Greater Bridgeport Planning Region (206) 254-4000
MRS. TERRI ANNE PISSERI A.P.R.N.
Nurse Practitioner (Family)
1073 N BENSON RD
FAIRFIELD, CT 06824
Greater Bridgeport Planning Region (203) 254-4011
JENNA INNAIMO
Counselor (School)
1073 N BENSON RD
FAIRFIELD, CT 06824
Greater Bridgeport Planning Region (203) 254-4000

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 Renee Divine's NPI number?

The NPI number for Renee Divine is 1245028521. It was assigned to this individual provider in the NPPES registry on April 28, 2025.

Where is Renee Divine located?

Renee Divine practices at 1073 N Benson Rd, Fairfield, CT 06824. The listed phone number is (203) 254-4000.

What is Renee Divine's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Renee Divine enrolled in Medicare?

Yes. Renee Divine is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Renee Divine was last updated on April 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.