Individual provider Active NPI

Derek Chiu, PT

  • Physical Therapist
  • Ontario, CA
National Provider Identifier
1770064123
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
295163 Issued in CA
Practice address
3200 Inland Empire Blvd Ste 100
Ontario, CA 91764-5569
Phone
(909) 945-5011
NPI assigned
Aug 23, 2018
Last updated
Aug 23, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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 295163 CA Primary

Addresses

Primary practice location

3200 Inland Empire Blvd Ste 100
Ontario, CA 91764-5569

Mailing address

5557 Coralwood PL
Fontana, CA 92336-5900

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
295163CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
True Physical Therapy, Inc. Physical Therapist CurrentSince Aug 1, 2022 Accepting new patients

Organizations & group practices 1

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": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1770064123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5557 CORALWOOD PL",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 INLAND EMPIRE BLVD STE 100",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917645569",
            "telephone_number": "909-945-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIU",
        "first_name": "DEREK",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-23",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "295163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; 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.