Individual provider Active NPI

Sanchu Chacko, RPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1801098645
Registry record updated Apr 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
021285-1 Issued in NY
Practice address
30 Wall St Ste 500
New York, NY 10005-2201
Phone
(212) 742-8000
Fax
(212) 742-1557
NPI assigned
Jun 4, 2007
Last updated
Apr 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2021

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 021285-1 NY Primary

Addresses

Primary practice location

30 Wall St Ste 500
New York, NY 10005-2201

Mailing address

30 Wall St Ste 500
New York, NY 10005-2201
Phone (212) 742-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040405000031 NY Practitioner - Physical Therapist in Private Practice 2860485240 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Visiting PT OT Services PLLCGroup PAC ID 1153721899, 22 clinicians

Practice addresses (Care Compare)

12 Ctr Dr
New Hyde Park, NY 11040-2302
Phone (646) 886-8687

85 Roosevelt Ave
Valley Stream, NY 11581-1133
Phone (646) 886-8687

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
021285-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Water Street Chiropractic PC CurrentSince Sep 23, 2021 Accepting new patients
Visiting PT OT Services PLLC Physical Therapist CurrentSince Jun 12, 2021 Accepting new patients
New York Plaza Physical Therapy PC Physical Therapist CurrentSince Sep 9, 2019 Accepting new patients
East Flushing Physical Therapy PC Physical Therapist CurrentSince Oct 22, 2003 Accepting new patients
Patriot Family Medical Associates PLLC CurrentSince Jun 12, 2021 Accepting new patients
Plaza One Physical Therapy PC Physical Therapist PastSince Aug 4, 2024 Accepting new patients
Five Towns Neurology, PC Past Accepting new patients
East Flushing Physical Therapy, PC Physical Therapist Past Accepting new patients
Astoria Physical Therapy Rehabilitation PC Physical Therapist PastSince Feb 22, 2019 Accepting new patients

Locations

1 New York Plz
New York, NY 10004
Phone (917) 582-2455

1 New York Plz
Ste L
New York, NY 10004
Phone (212) 256-1171

26 Broadway
Ste 931
New York, NY 10004
Phone (800) 369-3556

30 Wall St
Ste 500
New York, NY 10005
Phone (212) 742-8000

424 Madison Ave
Ste 1200
New York, NY 10017
Phone (212) 417-0092

85 Roosevelt Ave
Valley Stream, NY 11581
Phone (516) 791-9500

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GDEBBA

Organizations & group practices 9

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": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618012800000",
    "number": "1801098645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 WALL ST STE 500",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100052201",
            "telephone_number": "212-742-8000",
            "fax_number": "212-742-1557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 WALL ST STE 500",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100052201",
            "telephone_number": "212-742-8000",
            "fax_number": "212-742-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACKO",
        "first_name": "SANCHU",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2021-04-10",
        "certification_date": "2021-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "021285-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2021; 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.