Joseph Chacko, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704262115 Issued in MI

Practice address

3378 Fashion Square Blvd
Saginaw, MI 48603-2448

Phone

(989) 272-7610

NPI assigned

Mar 14, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: joseph.chacko@1084078566539268.direct.elationemr.com
• FHIR API: https://api.platform.athenahealth.com/8209/brand/5/csg/21/fhir/r4

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.

• Henry Ford Health Genesys Hospital

  • Podiatrist
  • Flint, MI
  • NPI 1528283033
  Medicare reassignment NPD
• Ascension Genesys Hospital

  • Skilled Nursing Facility
  • Grand Blanc, MI
  • NPI 1093125312
  NPD
• Henry Ford Health Genesys Hospital

  • Clinical Psychologist
  • Burton, MI
  • NPI 1932368537
  NPD

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

{
    "created_epoch": "1363219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1649511734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 DARWIN LN",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486033456",
            "telephone_number": "713-398-6514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3378 FASHION SQUARE BLVD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486032448",
            "telephone_number": "989-272-7610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACKO",
        "first_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-14",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704262115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Michigan University
• Cep America LLC
• Nyssa Cerny
• Juan Pablo Ceron-Parra
• Josephine R. Cervantes, LPC, PSYD
• Sophia Destiny Chacon
• Karen Nicole Chaffer, AU.D.
• Harsna Chahal
• Vijay Chaku, MD
• Chalet of Saginaw LLC

• Family Nurse Practitioner in Saginaw, MI
• Providers in Saginaw, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.