NPIMap

Individual provider Active NPI

Celin Chacko, MD

  • Diagnostic Radiology Physician
  • Bronx, NY
National Provider Identifier
1164562245
Registry record updated Feb 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
261414-1 Issued in NY
Practice address
3400 Bainbridge Ave
Bronx, NY 10467-2404
Phone
(718) 920-7536
Fax
(718) 652-5402
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 261414-1 NY Primary

Addresses

Primary practice location

3400 Bainbridge Ave
Bronx, NY 10467-2404

Mailing address

3400 Bainbridge Ave
Bronx, NY 10467-2404
Phone (718) 920-7536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120730000758 NY Practitioner - Diagnostic Radiology 2961668348 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Oklahoma College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbiadoctors/Newyork-PresbyterianimagingGroup PAC ID 6608141981, 106 clinicians
Trustees of Columbia University in the City of New YorkGroup PAC ID 8527972546, 2,262 clinicians

Practice addresses (Care Compare)

51 W 51St St
Suite 300
New York, NY 10019-1951
Phone (212) 326-8518

622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-9876

Hospital & facility affiliations

  • Hudson Valley Hospital Center Hospital, Cortlandt Manor, NY, CCN 330267
  • New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
261414-1NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York Current Accepting new patients
Trustees of Columbia University in the City of New York Diagnostic Radiology CurrentSince Aug 30, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Jan 29, 2013 Accepting new patients
Columbiadoctors/Newyork-Presbyterianimaging CurrentSince Aug 24, 2022 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Aug 30, 2022 Accepting new patients
New York University CurrentSince Mar 1, 2019 Accepting new patients
Columbia/Newyork-Presbyterian Advanced Imaging Inc. CurrentSince Nov 23, 2024 Accepting new patients
Montefiore Medical Center Diagnostic Radiology CurrentSince Jan 29, 2013 Accepting new patients
New York University CurrentSince Mar 1, 2019 Accepting new patients
Trustees of Columbia University in the City of New York Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

200 E Gun Hill Rd
Bronx, NY 10467
Phone (718) 798-5449

700 Stewart Ave
Garden City, NY 11530
Phone (516) 222-2020

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

51 W 51st St
Ste 300
New York, NY 10019
Phone (212) 342-3666

722 W 168th St
New York, NY 10032
Phone (212) 305-6754

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 10

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423785600000",
    "number": "1164562245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 BAINBRIDGE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672404",
            "telephone_number": "718-920-7536",
            "fax_number": "718-652-5402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 BAINBRIDGE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672404",
            "telephone_number": "718-920-7536",
            "fax_number": "718-652-5402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACKO",
        "first_name": "CELIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2015-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "261414-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.