Active NPI
Benjamin Stephen Chacko, M.D.
- Emergency Medicine Physician
- Iowa City, IA
National Provider Identifier
1770803884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- R-8963
- Practice address
- 200 Hawkins Dr
1008 RCP
Iowa City, IA 52242-1007 - Phone
- (319) 384-6511
- NPI assigned
- Jun 11, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | R-8963 | IA | Primary |
Addresses
Primary practice location
200 Hawkins Dr
1008 RCP
Iowa City, IA 52242-1007
Mailing address
200 Hawkins Dr
1008 RCP
Iowa City, IA 52242-1007
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-8963 | IA | MD | Emergency Medicine Physician |
Interoperability endpoints
- bchacko1206668@valleyhealth.direct-ci.com
- bchacko554831@direct.hopkinsmedicine.org
- bchacko28538@direct.wvuhsdirect.com
Organizations & group practices 5
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.
-
- Emergency Medicine Physician
- Franklin, VA
- NPI 1740529700
DC
-
- Critical Access Hospital
- Luray, VA
- NPI 1326040684
-
- Critical Access Hospital
- Woodstock, VA
- NPI 1033166442
-
- Rural Health Clinic/Center
- Woodstock, VA
- NPI 1952417735
-
- Emergency Medicine Physician
- Front Royal, VA
- NPI 1164442281
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276214400000",
"number": "1770803884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HAWKINS DR",
"address_2": "1008 RCP",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HAWKINS DR",
"address_2": "1008 RCP",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421007",
"telephone_number": "319-384-6511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHACKO",
"first_name": "BENJAMIN",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-11",
"last_updated": "2010-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IA",
"license": "R-8963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Iowa City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2010; 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.