Active NPI
Tobin Chakkala
- Student in an Organized Health Care Education/Training Program
- Fort Lauderdale, FL
National Provider Identifier
1609519248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510 - Phone
- (954) 355-4400
- NPI assigned
- Apr 20, 2022
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | FL | Primary |
Addresses
Primary practice location
1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510
Mailing address
12319 NW 52ND CT
Coral Springs, FL 33076-3435
Phone (954) 397-1905
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Physical Medicine and Rehabilitation
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Gainesville, FL 32610
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650412800000",
"number": "1609519248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12319 NW 52ND CT",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330763435",
"telephone_number": "954-397-1905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 S ANDREWS AVE",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333162510",
"telephone_number": "954-355-4400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAKKALA",
"first_name": "TOBIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-04-20",
"last_updated": "2022-04-20",
"certification_date": "2022-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; 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.