Andy Fata-Chan

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

04510001 Issued in NY

Practice address

182 Mulberry St
New York, NY 10012-4571

Phone

(734) 236-6349

NPI assigned

Sep 13, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Moment Physical Therapy, P.C.

  • Physical Therapy Clinic/Center
  • New York, NY
  • NPI 1700629557
  NPD (past)

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702080000000",
    "number": "1821767716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 MULBERRY ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100124571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 MULBERRY ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100124571",
            "telephone_number": "734-236-6349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATA-CHAN",
        "first_name": "ANDY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-13",
        "last_updated": "2023-12-09",
        "certification_date": "2023-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "04510001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fast Care Inc
• Fast Operating Corp
• Jarrett Fastman, MD
• Maria Fasulo
• Sammie Jo Fat, DDS
• Kristianna Fata-Chan, PT, DPT
• Esther Fatade, RN
• Stephan Fatade, RN
• Emily Nell Fatakhov, MD
• Olga Fatakhova, PA

• Physical Therapist in New York, NY
• Providers in New York, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2023; 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.