Ansu Susan Chacko, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

25062 Issued in MD

Practice address

176 Grand St
White Plains, NY 10601-4803

Phone

(914) 328-6080

Fax

(914) 328-6081

NPI assigned

May 18, 2012

Last updated

Oct 25, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• G. F.G Medical, P.C

  • Physical Medicine & Rehabilitation Physician
  • Bronx, NY
  • NPI 1053325894
  NPD (past)
• Wye Oak Healthcare Wellness LLC

  dba Cadia Wellness Maryland

  • Internal Medicine Physician
  • Hyattsville, MD
  • NPI 1497269336
  NPD (past)

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

{
    "created_epoch": "1337299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1285994616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14014 MARSH PIKE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217421638",
            "telephone_number": "301-864-2333",
            "fax_number": "877-828-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 GRAND ST",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106014803",
            "telephone_number": "914-328-6080",
            "fax_number": "914-328-6081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACKO",
        "first_name": "ANSU",
        "middle_name": "SUSAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-18",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "034937",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "25062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1447657507",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4374045-00",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "463684374",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theresa Cerar
• Leeann Cerbone, OTR/L
• Wilkins Cerda
• Brittany Cestone, LCSW
• Luis F Chabla-Penafiel, M.D.
• Jasmine Chacko, PHARMD
• Thomas Geevarghese Chacko, PT, DPT
• Julia Chafkin, PHD
• Erica R Chahade, LMT
• Yunghee Chai

• Physical Therapist in White Plains, NY
• Providers in White Plains, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.