Individual provider Active NPI

Charitha Chowdanahalli Yashavanth

  • Physical Therapist
  • Leander, TX
National Provider Identifier
1386485050
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1391568 Issued in TX
Practice address
1825 Crystal Falls Pkwy Ste 150
Leander, TX 78641-4041
Phone
(512) 817-5001
NPI assigned
Jun 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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 1391568 TX Primary

Addresses

Primary practice location

1825 Crystal Falls Pkwy Ste 150
Leander, TX 78641-4041

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Other practice location 1

4607 Menchaca Rd
Austin, TX 78745-1607
Phone (512) 916-1511

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240627002565 TX Practitioner - Physical Therapist in Private Practice 5597209809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

210 W Campbell Rd
Richardson, TX 75080-3512
Phone (972) 807-9168

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC CurrentSince Jun 10, 2024 Accepting new patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Jun 10, 2024 Accepting new patients
Kidtherapy, PLLC Physical Therapist PastSince Jun 1, 2024 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

17051 Dallas Pkwy
Ste 450
Addison, TX 75001
Phone (214) 272-8561

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

4015 Lemmon Ave
Dallas, TX 75219
Phone (469) 872-7461

2600 W 7th St
Ste 137
Fort Worth, TX 76107
Phone (682) 233-6462

1825 Crystal Falls Pkwy
Ste 150
Leander, TX 78641
Phone (512) 817-5001

410 W FM 544
Ste 105
Murphy, TX 75094
Phone (469) 606-5003

1450 E Belt Line Rd
Ste 200
Richardson, TX 75081
Phone (214) 210-4409

210 W Campbell Rd
Richardson, TX 75080
Phone (469) 709-4178

5400 Brodie Ln
Ste 295
Sunset Valley, TX 78745
Phone (512) 676-3949

Organizations & group practices 3

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": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1386485050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 CRYSTAL FALLS PKWY STE 150",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "786414041",
            "telephone_number": "512-817-5001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4607 Menchaca Rd",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787451607",
            "country_code": "US",
            "telephone_number": "512-916-1511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHOWDANAHALLI YASHAVANTH",
        "first_name": "CHARITHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1391568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leander, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.