Individual provider Active NPI

Divya Chetan

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1699058115
Registry record updated May 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
033795 Issued in NY
Practice address
1428 Victory Blvd
Staten Island, NY 10301-3908
Phone
(718) 698-3055
NPI assigned
Sep 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2012

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 033795 NY Primary

Addresses

Primary practice location

1428 Victory Blvd
Staten Island, NY 10301-3908

Mailing address

280 Marin Blvd
Apt 14K
Jersey City, NJ 07302-3654
Phone (201) 710-7035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033795NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services Inc Physical Therapist CurrentSince Jul 1, 2022 Accepting new patients
Mobile Therapy Services, Inc. Physical Therapist CurrentSince Feb 1, 2022 Accepting new patients

Locations

872 E Main St
Bridgewater, NJ 08807
Phone (908) 725-2995

407 W Delilah Rd
Pleasantville, NJ 08232
Phone (609) 289-2331

8 John Walsh Blvd
Ste 406A
Peekskill, NY 10566
Phone (732) 440-7858

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": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337472000000",
    "number": "1699058115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 MARIN BLVD",
            "address_2": "APT 14K",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073023654",
            "telephone_number": "201-710-7035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013908",
            "telephone_number": "718-698-3055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHETAN",
        "first_name": "DIVYA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2012-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "033795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.