Individual provider Active NPI

Monica Chitta

  • Physical Therapist
  • Daytona Beach, FL
National Provider Identifier
1285333880
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT32615 Issued in FL
Practice address
1717 N Clyde Morris Blvd Ste 140
Daytona Beach, FL 32117-5532
Phone
(386) 257-2672
NPI assigned
Mar 2, 2023
Last updated
Mar 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 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 PT32615 FL Primary

Addresses

Primary practice location

1717 N Clyde Morris Blvd Ste 140
Daytona Beach, FL 32117-5532

Mailing address

3585 SW 38TH Ter # 205
Ocala, FL 34474-5808
Phone (601) 604-0410

Other identifiers 1

IdentifierTypeStateIssuer
236MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230524000976 FL Practitioner - Physical Therapist in Private Practice 8628434289 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas Center for Physical Therapy Physical Therapist CurrentSince Apr 14, 2023 Accepting new patients

Locations

1717 N Clyde Morris Blvd
Ste 140
Daytona Beach, FL 32117
Phone (386) 257-2672

Networks

  • Freedom Health HMO Network

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": "1677715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1285333880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3585 SW 38TH TER # 205",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344745808",
            "telephone_number": "601-604-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 N CLYDE MORRIS BLVD STE 140",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175532",
            "telephone_number": "386-257-2672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHITTA",
        "first_name": "MONICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-02",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT32615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "236",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.