Individual provider Active NPI

Joaquin Charris, PT

  • Physical Therapist
  • Elmhurst, NY
National Provider Identifier
1205160033
Registry record updated Apr 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
026983 Issued in NY
Practice address
8131 Baxter Ave
Suite CD
Elmhurst, NY 11373-1315
Phone
(718) 424-5151
Fax
(718) 424-9119
NPI assigned
Sep 26, 2009
Last updated
Apr 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 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 026983 NY Primary

Addresses

Primary practice location

8131 Baxter Ave
Suite CD
Elmhurst, NY 11373-1315

Mailing address

8131 Baxter Ave
Suite CD
Elmhurst, NY 11373-1315
Phone (718) 424-5151

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110608000386 NY Practitioner - Physical Therapist in Private Practice 4789861386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8131 Baxter Ave
Suite CD
Elmhurst, NY 11373-1315
Phone (718) 424-5151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
026983NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Physical Therapy Rehab PC CurrentSince Aug 20, 2009 Accepting new patients

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, 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": "1253923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335484800000",
    "number": "1205160033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8131 BAXTER AVE",
            "address_2": "SUITE CD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731315",
            "telephone_number": "718-424-5151",
            "fax_number": "718-424-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8131 BAXTER AVE",
            "address_2": "SUITE CD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731315",
            "telephone_number": "718-424-5151",
            "fax_number": "718-424-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARRIS",
        "first_name": "JOAQUIN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-26",
        "last_updated": "2012-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "026983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.