Individual provider Active NPI

Petros Chalkitis, OTR/L

  • Specialist
  • Woodside, NY
National Provider Identifier
1174778963
Registry record updated Nov 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
013503-1 Issued in NY
Practice address
3972 65TH St
Woodside, NY 11377-3638
Phone
(646) 413-1199
NPI assigned
Nov 21, 2008
Last updated
Nov 21, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 013503-1 NY Primary

Addresses

Primary practice location

3972 65TH St
Woodside, NY 11377-3638

Mailing address

3972 65TH St
Woodside, NY 11377-3638

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013503-1NYMDSpecialist
013503NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1227225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227225600000",
    "number": "1174778963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3972 65TH ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3972 65TH ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773638",
            "telephone_number": "646-413-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHALKITIS",
        "first_name": "PETROS",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-21",
        "last_updated": "2008-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "013503-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.