Charissa Elazegui Culanag, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1210950 Issued in TX

Practice address

5811 Persimmon Dr
Tyler, TX 75707-2016

Phone

(432) 352-5900

NPI assigned

Mar 20, 2017

Last updated

Feb 16, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Charissa Elazegui Former name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthpro Heritage Rehab and Fitness LLCGroup PAC ID 6507832573, 976 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Georgetown, TX
  • NPI 1952531154
  Medicare reassignment Care Compare group NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Independence, MO
  • NPI 1871072462
  NPD

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1073054201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5811 PERSIMMON DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757072016",
            "telephone_number": "432-352-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5811 PERSIMMON DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757072016",
            "telephone_number": "432-352-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELAZEGUI CULANAG",
        "first_name": "CHARISSA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-20",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1210950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARISSA",
            "last_name": "ELAZEGUI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• W Gordon Eiland, PT SCS ATC
• Jessica Eitel, NP-C
• Ifunanya Ekechukwu, MD
• Mohamad El-Khatib
• Subbarao Elapavaluru, MD
• Jill Marie Elder, PHYSICAL THERAPIST
• Elect Home Health Care Inc.
• Uchechukwu S Elendu, MD
• Elevation Care Solutions, LLC
• Elevation Etx PLLC

• Physical Therapist in Tyler, TX
• Providers in Tyler, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.