Individual provider Active NPI

Divyesh M Mehta, DPM

  • Podiatrist
  • Winter Park, FL
National Provider Identifier
1861075178
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO4453 Issued in FL
Practice address
201 Moray LN Ste B
Winter Park, FL 32792-4122
Phone
(407) 993-2072
Fax
(407) 915-9615
NPI assigned
May 4, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X PO4453 FL
Foot Surgery Podiatrist 213ES0131X PO4453 FL
Foot & Ankle Surgery Podiatrist 213ES0103X PO4453 FL
Podiatrist 213E00000X PO4453 FL Primary

Addresses

Primary practice location

201 Moray LN Ste B
Winter Park, FL 32792-4122

Mailing address

15815 Shaddock Dr Ste 130
Winter Garden, FL 34787-5773
Phone (813) 400-1140

Other practice location 1

2500 W Lake Mary Blvd Ste 210
Lake Mary, FL 32746-3501
Phone (407) 956-4123

Other identifiers 2

IdentifierTypeStateIssuer
Y55EAOtherFLBCBS FL BLUE
16150823OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240515002172 FL Practitioner - Podiatry 0840631347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
All Podiatry Group Inc.Group PAC ID 0042252140, 42 clinicians

Practice addresses (Care Compare)

2500 W Lake Mary Blvd
Suite 210
Lake Mary, FL 32746-3501
Phone (407) 956-4123

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue130
Removal or shaving of skin growth114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
PO4453FLMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
All Podiatry Group Inc Podiatrist CurrentSince Jul 1, 2024 Accepting new patients
Anne McNamara DPM PL Podiatrist Past Accepting new patients

Locations

540 Medical Oaks Ave
Ste 101
Brandon, FL 33511
Phone (813) 681-3558

178 Wilshire Blvd
Casselberry, FL 32707
Phone (407) 331-4115

2500 W Lake Mary Blvd
Ste 210
Lake Mary, FL 32746
Phone (407) 328-0014

15815 Shaddock Dr
Ste 130
Winter Garden, FL 34787
Phone (407) 605-2321

201 Moray Ln
Ste B
Winter Park, FL 32792
Phone (407) 993-2072

201 Moray Ln
Winter Park, FL 32792
Phone (407) 645-3636

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1861075178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15815 SHADDOCK DR STE 130",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347875773",
            "telephone_number": "813-400-1140",
            "fax_number": "813-701-9132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MORAY LN STE B",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924122",
            "telephone_number": "407-993-2072",
            "fax_number": "407-915-9615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 W Lake Mary Blvd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Lake Mary",
            "state": "FL",
            "postal_code": "327463501",
            "country_code": "US",
            "telephone_number": "407-956-4123",
            "fax_number": "321-296-7190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "DIVYESH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-04",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "FL",
            "license": "PO4453",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "FL",
            "license": "PO4453",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO4453",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO4453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL BLUE",
            "identifier": "Y55EA",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "16150823",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.