Individual provider Active NPI

Chandani Borad

  • Physical Therapist
  • Bear, DE
National Provider Identifier
1578091468
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
J1-0003714 Issued in DE
Practice address
1859 Pulaski Hwy
Bear, DE 19701-1731
Phone
(732) 347-7203
NPI assigned
May 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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 J1-0003714 DE Primary

Addresses

Primary practice location

1859 Pulaski Hwy
Bear, DE 19701-1731

Mailing address

30 Crimson King Dr
Bear, DE 19701-2387
Phone (323) 477-2037

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210706000098 DE Practitioner - Physical Therapist in Private Practice 6901208503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bear Physical Therapy and Wellness IncGroup PAC ID 4183026784, 3 clinicians

Practice addresses (Care Compare)

1859 Pulaski Hwy
Bear, DE 19701-1731
Phone (201) 744-3276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bear Physical Therapy & Wellness Inc Physical Therapist CurrentSince Jun 8, 2021 Accepting new patients
Wilmington Physical Therapy & Wellness Physical Therapist PastSince Jun 6, 2021 Accepting new patients

Locations

1859 Pulaski Hwy
Bear, DE 19701
Phone (201) 744-3276

Organizations & group practices 2

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": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1578091468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 CRIMSON KING DR",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197012387",
            "telephone_number": "323-477-2037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1859 PULASKI HWY",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197011731",
            "telephone_number": "732-347-7203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORAD",
        "first_name": "CHANDANI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-23",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0003714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bear, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.