NPIMap

Individual provider Active NPI

Kavitha Kalvakuri, M.D.

  • Advanced Heart Failure and Transplant Cardiology Physician
  • Peoria, IL
National Provider Identifier
1780811513
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Heart Failure and Transplant Cardiology PhysicianTaxonomy code 207RA0001X
License
036130069 Issued in IL
Practice address
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone
(309) 624-8818
NPI assigned
Jun 19, 2009
Last updated
Apr 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125056355 IL
Cardiovascular Disease Physician 207RC0000X 036130069 IL
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X 036130069 IL Primary

Addresses

Primary practice location

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Mailing address

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 624-8818

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121019000458 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9931359312 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

5405 N Knoxville Ave
Peoria, IL 61614-5065
Phone (309) 691-4410

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125056355ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Graham Hospital Association CurrentSince Jul 28, 2025 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Graham Hospital Association Internal Medicine CurrentSince Jul 28, 2025 Accepting new patients
Graham Hospital Association Current Accepting new patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Dec 18, 2017 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Saint Francis Medical Center Cardiovascular Disease Past Accepting new patients

Locations

180 S Main St
Canton, IL 61520
Phone (309) 647-5240

210 W Walnut St
Canton, IL 61520
Phone (309) 647-5240

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

5405 N Knoxville Ave
Peoria, IL 61614
Phone (309) 691-4410

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Organizations & group practices 7

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

Hospital & facility affiliations 3

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": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1780811513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-624-8818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-624-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALVAKURI",
        "first_name": "KAVITHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-19",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125056355",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036130069",
            "primary": false
        },
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "IL",
            "license": "036130069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.