Active NPI
Chrysene Thiele Pande
- Physical Therapist
- Jamaica, NY
National Provider Identifier
1043091911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 051423-01
- Practice address
- 13052 146TH St
Jamaica, NY 11436-2307 - Phone
- (929) 486-8982
- NPI assigned
- Oct 9, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 012128-01 | NY | |
| Physical Therapist | 225100000X | 051423-01 | NY | Primary |
Addresses
Primary practice location
13052 146TH St
Jamaica, NY 11436-2307
Mailing address
13052 146TH St
Jamaica, NY 11436-2307
Phone (929) 486-8982
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051423-01 | NY | MD | Physical Therapist |
| 012128-01 | NY | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706400000000",
"number": "1043091911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13052 146TH ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114362307",
"telephone_number": "929-486-8982"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13052 146TH ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114362307",
"telephone_number": "929-486-8982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANDE",
"first_name": "CHRYSENE THIELE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-10-09",
"last_updated": "2024-01-28",
"certification_date": "2024-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NY",
"license": "012128-01",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "051423-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.