| Divya Karjala Chakkaravarthy, | |
|
62 Columbia St, Orlando, FL 32806-1115 | |
| (407) 514-3668 | |
| (321) 843-2196 |
| Full Name | Divya Karjala Chakkaravarthy |
|---|---|
| Gender | Female |
| Speciality | Anesthesiology |
| Experience | 18 Years |
| Location | 62 Columbia St, Orlando, Florida |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124451794 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 125063539 (Illinois) | Secondary |
| 207L00000X | Anesthesiology | ME180725 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Carle Health Proctor Hospital | Peoria, IL | Hospital |
| Carle Health Methodist Hospital | Peoria, IL | Hospital |
| Carle Health Pekin Hospital | Pekin, IL | Hospital |
| Saint Francis Medical Center | Peoria, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Methodist Medical Center Of Illinois | 1355259714 | 387 |
| Carle Health Care Incorporated | 3577515774 | 1592 |
| Entity Name | Methodist Medical Center of Illinois |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710198379 PECOS PAC ID: 1355259714 Enrollment ID: O20070922000105 |
| Entity Name | Carle Health Care Incorporated |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154653947 PECOS PAC ID: 3577515774 Enrollment ID: O20100513000829 |
| Mailing Address | Practice Location Address |
|---|---|
| Divya Karjala Chakkaravarthy, 62 Columbia St, Orlando, FL 32806-1115 Ph: (407) 514-3668 | Divya Karjala Chakkaravarthy, 62 Columbia St, Orlando, FL 32806-1115 Ph: (407) 514-3668 |
Dr. Paul David Thompson, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 601 E Rollins St, Orlando, FL 32803 Phone: 407-667-0444 Fax: 407-667-4338 |
Carlos A Archilla, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 13535 Nemours Pkwy, Orlando, FL 32827 Phone: 407-650-7715 Fax: 407-650-7724 |
Kristi Creel, Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 62 Columbia St, Orlando, FL 32806 Phone: 321-214-4903 Fax: 321-843-2196 |
Prabhav K Tella, MD, MPH Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 7243 Della Dr Fl 3, Orlando, FL 32819 Phone: 321-841-1570 Fax: 321-841-1569 |
Dean Sider, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 83 W Miller St, Orlando, FL 32806 Phone: 321-843-2584 |
Dr. Del T Kirkpatrick, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 1000 Woodcock Rd Ste 120, Orlando, FL 32803 Phone: 407-792-1968 Fax: 407-641-5179 |
Marnie B Robinson, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 92 W Miller St, Orlando, FL 32806 Phone: 321-841-4607 Fax: 321-841-4603 |