Active NPI
Achankunju A Chacko, MD
- Adult Medicine Physician
- Takoma Park, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- D20129
- Practice address
- 7610 Carroll Ave
Suite # 390
Takoma Park, MD 20912-6384 - Phone
- (301) 270-5522
- Fax
- (301) 270-4837
- NPI assigned
- Aug 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | D20129 | MD | Primary |
Addresses
Primary practice location
7610 Carroll Ave
Suite # 390
Takoma Park, MD 20912-6384
Mailing address
7610 Carroll Ave
Suite # 390
Takoma Park, MD 20912-6384
Phone (301) 270-5522
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7959214000 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Howard University College of Medicine, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
7249 Hanover Pkwy
Suite a
Greenbelt, MD 20770-3608
Phone (301) 613-8923
7610 Carroll Ave
Suite 390
Takoma Park, MD 20912-6323
Phone (301) 270-5522
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D20129 | MD | MD | Adult Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
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.
-
- Physical Therapist
- Greenbelt, MD
- NPI 1164602314
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital
- Rockville, MD
- NPI 1043216773
Inpatient rehabilitation facility
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508878414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7610 CARROLL AVE",
"address_2": "SUITE # 390",
"city": "TAKOMA PARK",
"state": "MD",
"postal_code": "209126384",
"telephone_number": "301-270-5522",
"fax_number": "301-270-4837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7610 CARROLL AVE",
"address_2": "SUITE # 390",
"city": "TAKOMA PARK",
"state": "MD",
"postal_code": "209126384",
"telephone_number": "301-270-5522",
"fax_number": "301-270-4837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHACKO",
"first_name": "ACHANKUNJU",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "MD",
"license": "D20129",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7959214000",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Takoma Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.