Individual provider Active NPI

Justin M Chacko

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1922430743
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
018155 Issued in NY
Practice address
800 Poly PL
Brooklyn, NY 11209-7104
Phone
(718) 836-6600
NPI assigned
Aug 2, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 018155 NY Primary

Addresses

Primary practice location

800 Poly PL
Brooklyn, NY 11209-7104

Mailing address

865 Plum Tree Rd W
Westbury, NY 11590-6031
Phone (516) 343-4349

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140325001578 NY Practitioner - Occupational Therapist in Private Practice 0547491177 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

800 E Gate Blvd
Garden City, NY 11530-2105
Phone (516) 745-8070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
JH Therapy Services Occupational Therapist CurrentSince Dec 1, 2024 Accepting new patients
Patriot Family Medical Associates PLLC CurrentSince Aug 18, 2023 Accepting new patients
JH Therapy Services Occupational Therapist CurrentSince Dec 1, 2024 Accepting new patients
Access Home Mobility & Safety Consultants, LLC CurrentSince Jun 18, 2023 Accepting new patients
Lifetime Redesign OT, PLLC CurrentSince Dec 1, 2024 Accepting new patients
Home Therapy OT PLLC Occupational Therapist CurrentSince Jul 1, 2025 Accepting new patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Occupational Therapist CurrentSince Jan 26, 2026 Accepting new patients
Propel Physical Therapy PC Occupational Therapist PastSince Nov 9, 2022 Accepting new patients
Rehabpro Physical Therapy, PC PastSince Jun 12, 2019 Accepting new patients

Locations

80 State St
Albany, NY 12207
Phone (415) 742-8411

805 Broadway
Ste 100
Amityville, NY 11701
Phone (631) 608-8874

800 E Gate Blvd
Garden City, NY 11530

50 Glen Cove Rd
Greenvale, NY 11548
Phone (516) 200-3545

228 Park Ave S
New York, NY 10003
Phone (215) 588-2144

11701 84th Ave
Richmond Hill, NY 11418
Phone (718) 441-0300

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

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1375401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1922430743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 PLUM TREE RD W",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115906031",
            "telephone_number": "516-343-4349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 POLY PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112097104",
            "telephone_number": "718-836-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACKO",
        "first_name": "JUSTIN",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-02",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "018155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.