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DIVINA GRACIA AVERILLA MD
NPI 1467504175
Family Medicine in Las Vegas, NV

Active since January 16, 2007PECOS EnrolledAccepts Medicare Assignment
8595 S DECATUR BLVD STE 108, LAS VEGAS, NV 89139(702) 948-1130(702) 688-8861 Get Directions Write a Review

NPPES record last updated: October 14, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 14, 2022, Dec 30, 2019, Aug 18, 2017 (3 updates tracked since 2017).

About Divina Gracia Averilla Md NPPES

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

DIVINA GRACIA AVERILLA MD (NPI 1467504175) is an individual family medicine provider in Las Vegas, Nevada, licensed in Nevada (7308) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS, maintains a secondary practice location in Las Vegas, and is a graduate of Other (1985).

NPPES Registry Identity

NPI1467504175
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDIVINA GRACIA AVERILLACredential: MD
Location Address8595 S DECATUR BLVD STE 108Las Vegas, NV 89139-7006
Mailing Address6355 S Buffalo Dr Fl 3Las Vegas, NV 89113-2133 · (702) 216-3346 · Fax (702) 671-6883
Phone(702) 948-1130
Fax(702) 688-8861
Sole ProprietorNo
Medical School CMSOtherGraduated 1985
Enumeration DateJanuary 16, 2007
Last NPPES UpdateOctober 14, 20223 updates tracked since enumeration
NPPES CertifiedOctober 14, 2022
✔ NPI 1467504175 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NV · 7308
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.
8595 S DECATUR BLVD STE 108, Las Vegas, NV 89139
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Other Names 1

Former Name (1)Divina Gracia Averilla-obena Md

Secondary Practice Location 1

Location 13131 La Canada St Ste 200Las Vegas, NV 89169-2579 · Phone (702) 369-5582 · Fax (702) 650-5148

Other Identifiers 3

Other7308NV · State License
Medicaid1202877NV
Medicaid1467504175NV

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

Divina Gracia Averilla 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 ID9436280930
PECOS Enrollment IDI20100628000455
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 89139 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
$88.51 typical visit price
range $57.07 – $173.24
Typical copayment $22.12 (range $14.26 – $43.31)
Most-billed visit code 99203
Established Patient
$100.60 typical visit price
range $18.27 – $140.96
Typical copayment $25.15 (range $4.56 – $35.24)
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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier11 claims11 services$67.80 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

ANNE MARIE CASTILLO NP-C
Nurse Practitioner (Family)
8595 S DECATUR BLVD STE 108
LAS VEGAS, NV 89139
Clark County (702) 948-1130
LAUREN BELOVE PA-C
Physician Assistant
8595 S DECATUR BLVD STE 108
LAS VEGAS, NV 89139
Clark County (702) 948-1130
IDA BERNADETTE PLAZA WILL APN-C
Nurse Practitioner (Family)
8595 S DECATUR BLVD STE 108
LAS VEGAS, NV 89139
Clark County (702) 948-1130

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 Divina Averilla's NPI number?

The NPI number for Divina Averilla is 1467504175. It was assigned to this individual provider in the NPPES registry on January 16, 2007. The provider is also known as Divina Gracia Averilla-Obena MD.

Where is Divina Averilla located?

Divina Averilla practices at 8595 S Decatur Blvd Ste 108, Las Vegas, NV 89139. The listed phone number is (702) 948-1130.

What is Divina Averilla's specialty?

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

Is Divina Averilla enrolled in Medicare?

Yes. Divina Averilla 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 Divina Averilla was last updated on October 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.