Charru Malik, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05009076A Issued in IN

Practice address

1534 119TH St
Whiting, IN 46394-1733

Phone

(219) 655-5285

Fax

(219) 655-5472

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Charru Chaudhry Former name

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Genesis Rehab Services LLCGroup PAC ID 4981862075, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Genesis Rehab Services LLC

  • Physical Therapy Clinic/Center
  • Saint John, IN
  • NPI 1790062594

  IN, Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official
• Moore Professional Childcare and Learning Center

  • Rehabilitation Clinic/Center
  • Blue Island, IL
  • NPI 1093018830
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1639263155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1534 119TH ST",
            "city": "WHITING",
            "state": "IN",
            "postal_code": "463941733",
            "telephone_number": "219-864-3300",
            "fax_number": "219-864-2569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1534 119TH ST",
            "city": "WHITING",
            "state": "IN",
            "postal_code": "463941733",
            "telephone_number": "219-655-5285",
            "fax_number": "219-655-5472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIK",
        "first_name": "CHARRU",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05009076A",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501012923",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM - MBWOUDE",
            "identifier": "000000491681",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM - 1ST AID PLUS",
            "identifier": "000000491371",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM - APT PLUS",
            "identifier": "000000491408",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARRU",
            "last_name": "CHAUDHRY",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Whiting, IN
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.