Individual provider Active NPI

Genesis J Chua

  • Physical Therapist
  • Punta Gorda, FL
National Provider Identifier
1447692256
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT20615 Issued in FL
Practice address
24017 Peppercorn Rd
Punta Gorda, FL 33955-4419
Phone
(239) 850-1323
NPI assigned
Jul 22, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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 PT20615 FL Primary

Addresses

Primary practice location

24017 Peppercorn Rd
Punta Gorda, FL 33955-4419

Mailing address

24017 Peppercorn Rd
Punta Gorda, FL 33955-4419

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191126001994 NY Practitioner - Physical Therapist in Private Practice 6507299989 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
039478NYMDPharmacist
PT20615FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Housecall PT & OT PLLC CurrentSince Nov 11, 2020 Accepting new patients
Core Physical Therapy Services PC Physical Therapist CurrentSince Jun 16, 2022 Accepting new patients
Rehab on Wheels OT PT PLLC Physical Therapist CurrentSince Nov 22, 2019 Accepting new patients
Link Home Therapy Services of Ny-PT OT SLP PLLC CurrentSince Jan 21, 2020 Accepting new patients
Prokinetics Physical Therapy P.C. Physical Therapist PastSince Jul 5, 2023 Accepting new patients

Locations

180 Sylvan Ave
Ste 4
Englewood Cliffs, NJ 07632
Phone (347) 841-8943

2003 Coney Island Ave
Brooklyn, NY 11223
Phone (347) 394-1600

8419 Bay Pkwy
Brooklyn, NY 11214
Phone (718) 259-0199

174 Bay 29th St
Ste C1
Brooklyn, NY 11214
Phone (646) 750-4455

108 S Franklin Ave
Ste 10
Valley Stream, NY 11580

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1447692256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24017 PEPPERCORN RD",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339554419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24017 PEPPERCORN RD",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339554419",
            "telephone_number": "239-850-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUA",
        "first_name": "GENESIS",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-22",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT20615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Punta Gorda, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; 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.