Individual provider Active NPI

Chantal Chacho

  • Physical Therapist
  • Hoboken, NJ
National Provider Identifier
1093559742
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
608 Washington St
Hoboken, NJ 07030-5170
Phone
(201) 484-0134
NPI assigned
Jun 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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 Primary

Addresses

Primary practice location

608 Washington St
Hoboken, NJ 07030-5170

Mailing address

909 18TH St Apt 2
Union City, NJ 07087-6766

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240909004640 NJ Practitioner - Physical Therapist in Private Practice 9234679960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Network IncGroup PAC ID 3476539776, 658 clinicians

Practice addresses (Care Compare)

608 Washington St
Hoboken, NJ 07030-5170
Phone (201) 484-0134

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network Inc. Physical Therapist CurrentSince Aug 27, 2024 Accepting new patients
Ivyrehab Network, Inc. Physical Therapist CurrentSince Aug 27, 2024 Accepting new patients

Locations

731 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-6780

454 Passaic St
Hackensack, NJ 07601
Phone (201) 488-7905

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1093559742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 18TH ST APT 2",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070876766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 WASHINGTON ST",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070305170",
            "telephone_number": "201-484-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACHO",
        "first_name": "CHANTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoboken, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.