Individual provider Active NPI

Brianna Rose Chachoute, PT, DPT

  • Physical Therapist
  • Princeton, NJ
National Provider Identifier
1639904329
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02286400 Issued in NJ
Practice address
660 Nassau Park Blvd
Princeton, NJ 08540-5949
Phone
(609) 606-1890
NPI assigned
Sep 3, 2024
Last updated
Sep 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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 40QA02286400 NJ Primary

Addresses

Primary practice location

660 Nassau Park Blvd
Princeton, NJ 08540-5949

Mailing address

660 Nassau Park Blvd
Princeton, NJ 08540-5949
Phone (609) 606-1890

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241004000202 NJ Practitioner - Physical Therapist in Private Practice 4981135712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Network IncGroup PAC ID 3476539776, 658 clinicians

Practice addresses (Care Compare)

330 N Harrison St
Suite 2
Princeton, NJ 08540-3500
Phone (631) 580-5200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02286400NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network Inc. Physical Therapist CurrentSince Aug 30, 2024 Accepting new patients
Ivyrehab Network, Inc. Physical Therapist CurrentSince Aug 30, 2024 Accepting new patients

Locations

731 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-6780

454 Passaic St
Hackensack, NJ 07601
Phone (201) 488-7905

330 N Harrison St
Ste 2
Princeton, NJ 08540
Phone (609) 924-0697

660 Nassau Park Blvd
#26C
Princeton, NJ 08540
Phone (609) 606-1890

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1725321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1639904329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 NASSAU PARK BLVD",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085405949",
            "telephone_number": "609-606-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 NASSAU PARK BLVD",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085405949",
            "telephone_number": "609-606-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACHOUTE",
        "first_name": "BRIANNA",
        "middle_name": "ROSE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-03",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02286400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; 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.