Anil Chacko, PHD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

017732-1 Issued in NY

Practice address

One Gustave L. Levy Place
Box 1230
New York, NY 10029

Phone

(716) 982-2464

NPI assigned

Jan 7, 2009

Last updated

Jan 7, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Sep 5, 2017 through Sep 5, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231286400000",
    "number": "1942447370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE GUSTAVE L. LEVY PLACE",
            "address_2": "BOX 1230",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029",
            "telephone_number": "716-982-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE GUSTAVE L. LEVY PLACE",
            "address_2": "BOX 1230",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029",
            "telephone_number": "716-982-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACKO",
        "first_name": "ANIL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-07",
        "last_updated": "2009-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "017732-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brent Ira Chabus, M.D.
• Zoe Avery Chace-Donahue, LCSW
• Amina Chace
• Faina Chachko, MD
• Abraham Chachoua, M.D.
• Diana Elza Chacko, RRT
• Elizabeth Mathews Chacko, M.D.
• Jenny Philip Chacko, AGPCNP-BC
• Lindsey Rachel Chacko, DO
• Marilyn Chacko, D.O

• Clinical Child & Adolescent Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Child & Adolescent Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.