Individual provider Active NPI

Rubin Jakob Chavarria, DPT

  • Physical Therapist
  • Towson, MD
National Provider Identifier
1245013135
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
29594 Issued in MD
Practice address
800 Kenilworth Dr
Towson, MD 21204-2201
Phone
(443) 441-0637
NPI assigned
Aug 15, 2023
Last updated
Aug 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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 29594 MD Primary

Addresses

Primary practice location

800 Kenilworth Dr
Towson, MD 21204-2201

Mailing address

8611 Oak Rd
Baltimore, MD 21219-2317
Phone (618) 409-5741

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231215002091 MD Practitioner - Physical Therapist in Private Practice 4284083254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

120 Sister Pierre Dr
Suite 303
Towson, MD 21204-7526
Phone (410) 337-9003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29594MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Nov 7, 2023 Accepting new patients
Felice Physical Therapy CurrentSince Aug 27, 2023 Accepting new patients
Privia Medical Group, LLC CurrentSince Nov 7, 2023 Accepting new patients
Felice Physical Therapy Physical Therapist CurrentSince Aug 27, 2023 Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

120 Sister Pierre Dr
Ste 303
Towson, MD 21204
Phone (410) 337-9003

800 Kenilworth Dr
Towson, MD 21204
Phone (443) 441-0637

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: rubin.chavarria.1@8042.direct.athenahealth.com

Organizations & group practices 5

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": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1245013135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8611 OAK RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212192317",
            "telephone_number": "618-409-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 KENILWORTH DR",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042201",
            "telephone_number": "443-441-0637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVARRIA",
        "first_name": "RUBIN",
        "middle_name": "JAKOB",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "29594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.