Individual provider Active NPI

Perveen Chattha, M.D.

  • Neurology Physician
  • Bronx, NY
National Provider Identifier
1215385653
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
311980-01 Issued in NY
Practice address
1250 Waters PL
Bronx, NY 10461-2720
Phone
(929) 263-3866
NPI assigned
May 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD61495765 WA
Neurology Physician 2084N0400X 311980-01 NY Primary

Addresses

Primary practice location

1250 Waters PL
Bronx, NY 10461-2720

Mailing address

1250 Waters PL
Bronx, NY 10461-2720
Phone (929) 263-3866

Other practice location 1

834 Sheridan St
Port Townsend, WA 98368-2443
Phone (360) 774-8125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240216003228 WA Practitioner - Neurology 6800188822 Reassigns benefits to 1 organization
I20250530001895 CA Practitioner - Neurology 6800188822 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
311980-01NYMDNeurology Physician
MD61495765WAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Contra Costa County CurrentSince May 13, 2025 Accepting new patients
Jefferson County Public Hospital District No 2 CurrentSince Mar 1, 2024 Accepting new patients
Contra Costa County CurrentSince May 13, 2025 Accepting new patients
Contra Costa County Current Accepting new patients

Locations

2500 Alhambra Ave
Martinez, CA 94553
Phone (925) 370-5000

2311 Loveridge Rd
Pittsburg, CA 94565
Phone (800) 495-8885

2523 El Portal Dr
Ste 206
San Pablo, CA 94806
Phone (510) 215-3730

834 Sheridan St
Port Townsend, WA 98368
Phone (360) 344-0400

1200 W Sims Way
Ste C
Port Townsend, WA 98368
Phone (360) 385-6297

934 Sheridan St
Port Townsend, WA 98368
Phone (360) 385-5330

Interoperability endpoints

  • Direct secure messaging: pchattha3169450@wm.providencedirect.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1215385653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 WATERS PL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612720",
            "telephone_number": "929-263-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 WATERS PL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612720",
            "telephone_number": "929-263-3866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "834 Sheridan St",
            "address_purpose": "LOCATION",
            "city": "Port Townsend",
            "state": "WA",
            "postal_code": "983682443",
            "country_code": "US",
            "telephone_number": "360-774-8125",
            "fax_number": "360-774-8127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHATTHA",
        "first_name": "PERVEEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-26",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD61495765",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "311980-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.