Peter Chang, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305206545 Issued in VA

Practice address

10128 W Broad St BLDG 3
Glen Allen, VA 23060-6761

Phone

(804) 217-9210

Fax

(804) 217-9213

NPI assigned

Jul 19, 2010

Last updated

Nov 12, 2025By the provider in NPPES

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tidewater Physical Therapy LLCGroup PAC ID 6406759281, 225 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.16 of 100Reported as group

Quality

85.78

Promoting interoperability

99

Improvement activities

40

Cost

75.6

Medicare enrollment (NPD)

Enrolled

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

• Tidewater Physical Therapy, LLC

  dba Pivot Physical Therapy of Virginia

  • Physical Therapist
  • Glen Allen, VA
  • NPI 1457389595
  Medicare reassignment Care Compare group NPD
• Richmond Physical Therapy Corp

  • Physical Therapist
  • Richmond, VA
  • NPI 1518936459
  Medicare reassignment NPD
• Tidewater Physical Therapy, LLC

  • Physical Therapist
  • Richmond, VA
  • NPI 1003114083
  NPD
• Tidewater Physical Therapy, LLC

  dba Pivot Physical Therapy of Virginia

  • Physical Therapist
  • Roanoke, VA
  • NPI 1437664356
  NPD

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

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1750694899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-6200",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10128 W BROAD ST BLDG 3",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230606761",
            "telephone_number": "804-217-9210",
            "fax_number": "804-217-9213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Willow Lawn Dr",
            "address_2": "ste 230",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232303003",
            "country_code": "US",
            "telephone_number": "804-340-1193",
            "fax_number": "804-340-1930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "PETER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-19",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305206545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS (PHYSICAL THERAPY)",
            "identifier": "365769",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9492613",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00871014",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Center for Physical Therapy & Sports Medicine, PC
• Centerwell Senior Primary Care VA PLLC (CenterWell Senior Primary Care-Twin Hickory)
• Central Virginia Disc Center (Richmond Disc Center)
• CH Specialty Services VA LLC
• Shruthi Manjunatha Chandrashekhar Vijayalakshmi, MD
• Joanna Chaplin, OTD, OTR/L
• Chapters Health Hospice, Inc. (Chapters Health Hospice)
• Andre Charles, DC
• Mallika R Chary, DDS
• Nicole Chelonis

• Physical Therapist in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; 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.