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DR. MIRA N DVIVEDI M.D.
NPI 1710327580
Family Medicine in Decatur, IL

Active since June 26, 2013PECOS EnrolledAccepts Medicare Assignment
250 W KENWOOD AVE, DECATUR, IL 62526(217) 872-3800(217) 872-0849 Get Directions Write a Review

NPPES record last updated: December 3, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Mira N Dvivedi M.d. NPPES

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

DR. MIRA N DVIVEDI M.D. (NPI 1710327580) is an individual family medicine provider in Decatur, Illinois, licensed in Illinois (125-064054) and active in the NPI registry since June 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1710327580
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. MIRA N DVIVEDICredential: M.D.
Location Address250 W KENWOOD AVEDecatur, IL 62526-4371
Mailing Address250 W Kenwood AveDecatur, IL 62526-4371 · (217) 872-3800 · Fax (217) 872-0849
Phone(217) 872-3800
Fax(217) 872-0849
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateJune 26, 2013
Last NPPES UpdateDecember 3, 2021
✔ NPI 1710327580 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 125-064054
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.
250 W KENWOOD AVE, Decatur, IL 62526
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Mira N Dvivedi M.d. 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 ID4082844469
PECOS Enrollment IDI20160923000427
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.

Medicare Billing Reassignment

Medicare enrollment records show Mira Dvivedi reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
1,600 mi
Health Maintenance Organization
3527 W FLORIDA AVE
Hemet, CA 92545
  • Reassigned Medicare billing, California enrollment
  • Also billed through NPI 1225060742 (California)
  • 5,228 clinicians in this Medicare group
NPI 1013433465 (877) 608-0044

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62526 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

SARA D. MURPHY APRN
Nurse Practitioner (Family)
250 W KENWOOD AVE
DECATUR, IL 62526
Macon County (217) 528-7541
AMISHA KAMATH MD
Family Medicine
250 W KENWOOD AVE
DECATUR, IL 62526
Macon County (217) 872-3800
DR. JOHNNY C TENEGRA M.D.
Family Medicine
250 W KENWOOD AVE
DECATUR, IL 62526
Macon County (217) 872-3800
SPRINFIELD CLINIC LLP
Non-Pharmacy Dispensing Site
250 W KENWOOD AVE
DECATUR, IL 62526
Macon County (217) 428-3424
LAURA E LAW PA-C
Physician Assistant (Medical)
250 W KENWOOD AVE
DECATUR, IL 62526
Macon County (217) 872-3800
HARVINDER DHILLON MD
Family Medicine
250 W KENWOOD AVE
DECATUR, IL 62526
Macon County (217) 872-3800
DR. CYNTHIA D MARSCHNER DO
Family Medicine
250 W KENWOOD AVE
DECATUR, IL 62526
Macon County (217) 528-7541
DR. DAVID IBRAHIM M.D.
Family Medicine
250 W KENWOOD AVE
DECATUR, IL 62526
Macon County (217) 872-3800

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 Mira Dvivedi's NPI number?

The NPI number for Mira Dvivedi is 1710327580. It was assigned to this individual provider in the NPPES registry on June 26, 2013.

Where is Mira Dvivedi located?

Mira Dvivedi practices at 250 W Kenwood Ave, Decatur, IL 62526. The listed phone number is (217) 872-3800.

What is Mira Dvivedi's specialty?

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

Is Mira Dvivedi enrolled in Medicare?

Yes. Mira Dvivedi 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.

Which organization bills Medicare for Mira Dvivedi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mira Dvivedi reassigns Medicare benefits to Southern California Permanente Medical Group (Hemet, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mira Dvivedi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mira Dvivedi was last updated on December 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.