Individual provider Active NPI

Peter Ikem Chukwuneke, P.T.

  • Physical Therapist
  • Bronx, NY
National Provider Identifier
1093009649
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
031468 Issued in NY
Practice address
392 E Tremont Avenue
Bronx, NY 10453
Phone
(646) 354-7330
Fax
(347) 602-5331
NPI assigned
May 31, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 031468 NY Primary

Addresses

Primary practice location

392 E Tremont Avenue
Bronx, NY 10453

Mailing address

392 E Tremont Ave
Bronx, NY 10457-4241
Phone (646) 354-7330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140520000162 NY Practitioner - Physical Therapist in Private Practice 8022231083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affinity Rehabilitation LLPGroup PAC ID 4789843376, 114 clinicians

Practice addresses (Care Compare)

500 N Columbus Ave
Mount Vernon, NY 10552-1335
Phone (914) 266-3796

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
031468NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson in Home Physical Therapy and Occupational Therapy PLLC Physical Therapist PastSince Jan 4, 2022 Accepting new patients

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": "1306800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1093009649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "392 E TREMONT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104574241",
            "telephone_number": "646-354-7330",
            "fax_number": "347-602-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "392 E TREMONT AVENUE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10453",
            "telephone_number": "646-354-7330",
            "fax_number": "347-602-5331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUKWUNEKE",
        "first_name": "PETER",
        "middle_name": "IKEM",
        "name_prefix": "Dr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-31",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "031468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; 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.