Individual provider Active NPI

Divya Karjala Chakkaravarthy

  • Anesthesiology Physician
  • Orlando, FL
National Provider Identifier
1124451794
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME180725 Issued in FL
Practice address
62 Columbia St
Orlando, FL 32806-1115
Phone
(407) 514-3668
Fax
(321) 843-2196
NPI assigned
Aug 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 125063539 IL
Anesthesiology Physician 207L00000X ME180725 FL Primary

Addresses

Primary practice location

62 Columbia St
Orlando, FL 32806-1115

Mailing address

62 Columbia St
Orlando, FL 32806-1115
Phone (407) 514-3668

Other practice location 1

555 W Madison St
#3511
Chicago, IL 60661-2514
Phone (989) 854-6622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190201001644 IL Practitioner - Anesthesiology 1456645936 Reassigns benefits to 2 organizations
I20260527002615 FL Practitioner - Anesthesiology 1456645936

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Medical Center of IllinoisGroup PAC ID 1355259714, 387 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-5654

5409 N Knoxville Ave
Peoria, IL 61614-5069
Phone (309) 691-1000

600 S 13TH St
Pekin, IL 61554-4936

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

  • Carle Health Proctor Hospital Hospital, Peoria, IL, CCN 140013
  • Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209
  • Carle Health Pekin Hospital Hospital, Pekin, IL, CCN 140120
  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125063539ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Medical Center of Illinois Anesthesiology CurrentSince Dec 11, 2018 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Dec 11, 2018 Accepting new patients
Carle Health Care Incorporated Anesthesiology CurrentSince Jan 1, 2026 Accepting new patients

Locations

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1124451794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 COLUMBIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061115",
            "telephone_number": "407-514-3668",
            "fax_number": "321-843-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 COLUMBIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061115",
            "telephone_number": "407-514-3668",
            "fax_number": "321-843-2196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 W Madison St",
            "address_2": "#3511",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606612514",
            "country_code": "US",
            "telephone_number": "989-854-6622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KARJALA CHAKKARAVARTHY",
        "first_name": "DIVYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-18",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "125063539",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME180725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.