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DR. DIVYASUDHA MOHAN D.O.
NPI 1336597780
Family Medicine in Philadelphia, PA

Active since May 26, 2016PECOS EnrolledAccepts Medicare Assignment
1139 E LUZERNE ST, PHILADELPHIA, PA 19124(215) 537-5094(215) 537-5096 Get Directions Write a Review

NPPES record last updated: October 2, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 7, 2024, May 25, 2021 (2 updates tracked since 2021).

About Dr. Divyasudha Mohan D.o. NPPES

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

DR. DIVYASUDHA MOHAN D.O. (NPI 1336597780) is an individual family medicine provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (OS019595) and active in the NPI registry since May 2016. She is enrolled in Medicare PECOS, is affiliated with Jefferson Health- Northeast, and is a graduate of Edward Via Col Of Osteo Medicine-virginia Campus (2016).

NPPES Registry Identity

NPI1336597780
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. DIVYASUDHA MOHANCredential: D.O.
Location Address1139 E LUZERNE STPhiladelphia, PA 19124-5234
Mailing Address10800 Knights RdPhiladelphia, PA 19114-4200 · (215) 612-5161
Phone(215) 537-5094
Fax(215) 537-5096
Sole ProprietorNo
Medical School CMSEdward Via Col Of Osteo Medicine-virginia CampusGraduated 2016
Enumeration DateMay 26, 2016
Last NPPES UpdateOctober 2, 20252 updates tracked since enumeration
NPPES CertifiedOctober 2, 2025
✔ NPI 1336597780 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in PA · OS019595
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.
Also ListedEmergency MedicineTaxonomy 207P00000X · License OS019595 (PA)
1139 E LUZERNE ST, Philadelphia, PA 19124
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Other Names 1

Other Name (5)Dr. Divya Mohan D.o

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

Dr. Divyasudha Mohan D.o. 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 ID3779982442
PECOS Enrollment IDI20210528002206
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.
51 services29 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.
46 services27 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.
19 services19 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
12 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Jefferson Health- Northeast

Acute Care Hospitals · Philadelphia, PA
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390115
Location10800 Knights RoadPhiladelphia, PA 19114 · Philadelphia County
Emergency services

Thomas Jefferson University Hospital

Acute Care Hospitals · Philadelphia, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390174
Location111 South 11th StreetPhiladelphia, PA 19107 · Philadelphia County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19124 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 3

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

JONATHAN DAVID PICKER LCSW
Social Worker (Clinical)
1139 E LUZERNE ST
PHILADELPHIA, PA 19124
Philadelphia County (215) 537-5094
ARIA HEALTH PHYSICIAN SERVICES - JUNIATA
Family Medicine
1139 E LUZERNE ST
PHILADELPHIA, PA 19124
Philadelphia County (215) 537-5094
AEKATA SHAH
Family Medicine
1139 E LUZERNE ST
PHILADELPHIA, PA 19124
Philadelphia County (215) 537-5094

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 Divyasudha Mohan's NPI number?

The NPI number for Divyasudha Mohan is 1336597780. It was assigned to this individual provider in the NPPES registry on May 26, 2016. The provider is also known as Dr. Divya Mohan D.O.

Where is Divyasudha Mohan located?

Divyasudha Mohan practices at 1139 E Luzerne St, Philadelphia, PA 19124. The listed phone number is (215) 537-5094.

What is Divyasudha Mohan's specialty?

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

Is Divyasudha Mohan enrolled in Medicare?

Yes. Divyasudha Mohan 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.

Is Divyasudha Mohan affiliated with any hospitals?

According to CMS data, Divyasudha Mohan is affiliated with Jefferson Health- Northeast and Thomas Jefferson University Hospital.

When was this NPI record last updated?

The NPPES record for Divyasudha Mohan was last updated on October 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.