Charlie J Celadina II, PT

Individual provider Active NPI Physical Therapist · Plymouth, IN

NPI 1134050453 · NPPES record last updated May 26, 2026

Key facts

NPI
1134050453
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
05008279A (IN)
Practice address
635 Oakhill Ave
Plymouth, IN 46563-3064
Phone
(574) 936-9981
Fax
(574) 936-9307
NPI assigned
May 26, 2026
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

644 E 9TH St
Indianapolis, IN 46202-3463

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20260623000763 IN Practitioner - Physical Therapist in Private Practice 3375016264 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
05008279AINMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05008279A IN Yes

Addresses

Primary practice location

635 Oakhill Ave
Plymouth, IN 46563-3064

Mailing address

11384 Crocus CT
Plymouth, IN 46563-7665

Other providers in Plymouth, IN

All providers in Plymouth, IN · Physical Therapist in Indiana

Sources for this page

Verify at the official NPI Registry.