Individual provider Active NPI

Jenny Chamoun, PT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1467408757
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
24339 Issued in NY
Practice address
180 W 80TH St
New York, NY 10024-6378
Phone
(212) 595-4500
Fax
(212) 595-4578
NPI assigned
May 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

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 24339 NY Primary

Addresses

Primary practice location

180 W 80TH St
New York, NY 10024-6378

Mailing address

180 W 80TH St
New York, NY 10024-6378
Phone (212) 595-4500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041108000992 NY Practitioner - Physical Therapist in Private Practice 6103889415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
New York Medical College, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Miccass Physical Therapy PCGroup PAC ID 8527100858, 10 clinicians

Practice addresses (Care Compare)

246 Columbus Ave
New York, NY 10023-3331
Phone (212) 595-4500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24339NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Miccass Physical Therapy, P.C. CurrentSince Dec 1, 2009 Accepting new patients

Locations

180 W 80th St
New York, NY 10024
Phone (212) 579-2858

246 Columbus Ave
#C
New York, NY 10023
Phone (212) 595-4500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422921600000",
    "number": "1467408757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 W 80TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246378",
            "telephone_number": "212-595-4500",
            "fax_number": "212-595-4578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 W 80TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246378",
            "telephone_number": "212-595-4500",
            "fax_number": "212-595-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMOUN",
        "first_name": "JENNY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2015-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "24339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; 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.