Sandra Chan

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1365615 Issued in TX

Practice address

1201 S Interstate 35 Ste 105
Round Rock, TX 78664-6646

Phone

(512) 310-7665

Fax

(512) 310-9228

NPI assigned

Sep 22, 2022

Last updated

Oct 13, 2022By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vista JV Partners LLCGroup PAC ID 3274998224, 126 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sandra.chan.1@15749.direct.athenahealth.com

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.

• Vista JV Partners LLC

  dba Vista Physical Therapy

  • Multi-Specialty Clinic/Center
  • Lake Worth, TX
  • NPI 1326753377

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Reavis Rehab & Wellness Center, Inc.

  dba Reavis Rehab

  • Rehabilitation Clinic/Center
  • Round Rock, TX
  • NPI 1265448054
  NPD (past)

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1518680768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 S INTERSTATE 35 STE 105",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786646646",
            "telephone_number": "512-310-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S INTERSTATE 35 STE 105",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786646646",
            "telephone_number": "512-310-7665",
            "fax_number": "512-310-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "SANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-22",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1365615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXECUTIVE COUNCIL OF PHYSICAL THERAPY EXAMINERS",
            "identifier": "1365615",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Chamberlain, RBT
• Brandi Vennessa Chambers
• Brian Chambers
• Terry C Chambless, M.D.,P.A.
• Jeremy Champoux, RN
• Tracy Chan, NP
• Yan Wei Chan
• Montique Chance, LPC
• Chancellor Professional Counseling Services PLLC
• Priya Chandna, RN

• Physical Therapist in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.