Sophia Rachel Chacko, R.N., C.P.R.N

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP014506 Issued in PA

Practice address

925 Chestnut St
5TH Floor
Philadelphia, PA 19107-4216

Phone

(267) 339-3500

Fax

(215) 503-0580

NPI assigned

Jan 22, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Clinical Care Associates of the University of Pennsylvania Health

  • Internal Medicine Physician
  • Radnor, PA
  • NPI 1972682995
  Medicare reassignment NPD
• Reconstructive Orthopaedic Associates II LLC

  • Orthopaedic Surgery Physician
  • Philadelphia, PA
  • NPI 1861433278
  Medicare reassignment NPD
• Clinical Care Associates of the University of Pennsylvania Health

  • Psychologist
  • West Chester, PA
  • NPI 1649940107
  NPD
• Clinical Care Associates of the University of Pennsylvania Health Syst

  • Orthopaedic Foot and Ankle Surgery Physician
  • Philadelphia, PA
  • NPI 1942319777
  NPD
• Reconstructive Orthopaedic Associates II LLC

  • Prosthetic/Orthotic Supplier
  • Philadelphia, PA
  • NPI 1497571830
  NPD

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519084800000",
    "number": "1922497361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT ST",
            "address_2": "5TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074216",
            "telephone_number": "267-339-3500",
            "fax_number": "215-503-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT ST",
            "address_2": "5TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074216",
            "telephone_number": "267-339-3500",
            "fax_number": "215-503-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACKO",
        "first_name": "SOPHIA",
        "middle_name": "RACHEL",
        "credential": "R.N., C.P.R.N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-22",
        "last_updated": "2018-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR17168500",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN650774",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP014506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Chacko, D.O.
• Liju Chacko, CRT
• Lincy Chacko
• Linsey Sara Chacko, CRNP
• Shireen Renate Chacko, MD
• Nathan Chaclas
• Daria Chacon, MD
• Laura Claire Chacon
• Chad Home Health Agency Inc
• Chad Home Health Agency, Inc.

• Family Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2018; 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.

Verify at the official NPI Registry.