Individual provider Active NPI

Charmaine Irish Longakit Juario, PT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1922732809
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070023561 Issued in IL
Practice address
1345 Avenue of the Americas
11TH Floor
New York, NY 10105
Phone
(212) 981-1977
Fax
(646) 786-4026
NPI assigned
Jul 15, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 041321 NY
Physical Therapist 225100000X 070023561 IL Primary

Addresses

Primary practice location

1345 Avenue of the Americas
11TH Floor
New York, NY 10105

Mailing address

24 Sunnyside Dr
Springfield, IL 62702
Phone (217) 610-0058

Other identifiers 3

IdentifierTypeStateIssuer
236MedicaidDC
568946544OtherBCBS
5874OtherHEALTH PARTNERS

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL securerecords.sanford.html

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221206002297 IL Practitioner - Physical Therapist in Private Practice 7719356286 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Rehab Therapy Partners PLLCGroup PAC ID 3173988367, 5 clinicians

Practice addresses (Care Compare)

6201 W Touhy Ave
Suite 2
Chicago, IL 60646-1119
Phone (773) 701-8048

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041321NYMDPharmacist
070023561ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Rehab PC Physical Therapist CurrentSince Sep 13, 2022 Accepting new patients
Total Rehab Therapy Partners, PLLC Physical Therapist CurrentSince Mar 10, 2023 Accepting new patients
Total Rehab PC Physical Therapist CurrentSince Sep 13, 2022 Accepting new patients
Dependable Care Staffing, LLC Physical Therapist CurrentSince Aug 7, 2024 Accepting new patients

Locations

6201 W Touhy Ave
Ste 2
Chicago, IL 60646
Phone (847) 236-2450

4920 N Central Ave
Ste 1A
Chicago, IL 60630
Phone (773) 736-3338

7126 N Lincoln Ave
Lincolnwood, IL 60712
Phone (847) 583-9189

455 S Roselle Rd
Ste 101
Schaumburg, IL 60193
Phone (231) 690-6828

9933 Lawler Ave
Ste 206B
Skokie, IL 60077
Phone (847) 983-8417

Organizations & group practices 4

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": "1657843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1922732809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 SUNNYSIDE DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "62702",
            "telephone_number": "217-610-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 AVENUE OF THE AMERICAS",
            "address_2": "11TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10105",
            "telephone_number": "212-981-1977",
            "fax_number": "646-786-4026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUARIO",
        "first_name": "CHARMAINE IRISH",
        "middle_name": "LONGAKIT",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-15",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "041321",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070023561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "236",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "568946544",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "5874",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "securerecords.sanford.html",
            "affiliation": "N",
            "address_1": "1345 Avenue of the Americas",
            "address_2": "11th floor",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "10105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jul 15, 2022; 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.