Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kacey Divincenzo, PA-C

Individual provider Physician Assistant · NPI 1558082644

Kacey Divincenzo, PA-C is a Physician Assistant in Warren, Ohio. Qualified in 2022, 4 years ago. Practices with Comprehensive Rehab Consultants PLLC, a 250-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
4
Licensed in
OH
In the registry since
2022
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2473 N Rd NE
Warren, OH 44483-3054
Phone: (330) 372-2251
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 250 Debartolo Pl Ste B, Youngstown, OH 44512-7004 — (234) 683-1015

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 50.007802RX (OH)

Record details

NPI number1558082644
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 7, 2022
Last updated in NPPESDecember 30, 2025
Certification dateDecember 30, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Comprehensive Rehab Consultants Pllc — 250 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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