Individual provider Active NPI

Justin Chuck, DPT

  • Physical Therapist
  • Pasadena, CA
National Provider Identifier
1811357338
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT291082 Issued in CA
Practice address
1021 E Walnut St Ste 100
Pasadena, CA 91106-1478
Phone
(626) 400-9524
Fax
(626) 355-1628
NPI assigned
Feb 25, 2016
Last updated
Jul 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 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 PT291082 CA Primary

Addresses

Primary practice location

1021 E Walnut St Ste 100
Pasadena, CA 91106-1478

Mailing address

550 Mountain Crest Rd
Duarte, CA 91010-1513
Phone (626) 400-9524

Other practice location 1

1323 S Shamrock Ave
Monrovia, CA 91016-4245
Phone (626) 400-9524

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160412002210 CA Practitioner - Physical Therapist in Private Practice 4981902723 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

411 E Huntington Dr
Suite 301
Arcadia, CA 91006-3735
Phone (626) 400-9524

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT291082CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aim Physical Therapy, Inc. CurrentSince Jan 7, 2020 Accepting new patients
Body Synergy Physical Therapy, Inc. Physical Therapist CurrentSince Mar 1, 2016 Accepting new patients

Locations

411 E Huntington Dr
Ste 301
Arcadia, CA 91006
Phone (626) 400-9524

1021 E Walnut St
Ste 100
Pasadena, CA 91106
Phone (626) 215-8475

600 S Lake Ave
Ste 306
Pasadena, CA 91106
Phone (626) 356-4948

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, 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": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1811357338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MOUNTAIN CREST RD",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910101513",
            "telephone_number": "626-400-9524",
            "fax_number": "626-355-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 E WALNUT ST STE 100",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911061478",
            "telephone_number": "626-400-9524",
            "fax_number": "626-355-1628"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1323 S Shamrock Ave",
            "address_purpose": "LOCATION",
            "city": "Monrovia",
            "state": "CA",
            "postal_code": "910164245",
            "country_code": "US",
            "telephone_number": "626-400-9524",
            "fax_number": "626-355-1628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUCK",
        "first_name": "JUSTIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-25",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT291082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.