NPIMap

Organization Active NPI

Freeman M Chakara PC

  • Clinical Neuropsychologist
  • Leola, PA
National Provider Identifier
1952328833
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PS009409 Issued in PA
Legal business name
FREEMAN M CHAKARA PC
Practice address
219 W Main St
Leola, PA 17540-1753
Phone
(717) 556-0149
Fax
(717) 556-0149
NPI assigned
Jul 16, 2006
Last updated
Jul 2, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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

Authorized official

Name
Freeman M Chakara, PSYDNPI 1336190966
Title
Owner
Phone
(717) 556-0149

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PS009409 PA Primary

Addresses

Primary practice location

219 W Main St
Leola, PA 17540-1753

Mailing address

2003 Old Rothsville Rd
Lititz, PA 17543-9133
Phone (717) 556-0149

Other identifiers 5

IdentifierTypeStateIssuer
001897858MedicaidPA
001334567OtherPAHIGHMARK BLUE SHIELD
02271001OtherPACAPITAL BLUE CROSS
1548467OtherPAGATEWAY MEDICARE ASSURED
680015251OtherPARAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061207000325 PA Part B Supplier - Clinic/Group Practice 8527061902 Receives reassigned benefits from 10 practitioners
Practice locations: Lancaster, PA

National Provider Directory

National Provider Directory

Locations

1525 Oregon Pike
Ste 501
Lancaster, PA 17601
Phone (717) 397-1400

600 Olde Hickory Rd
Ste 211
Lancaster, PA 17601
Phone (717) 556-0149

219 W Main St
Leola, PA 17540
Phone (717) 556-0149

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372723200000",
    "number": "1952328833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 OLD ROTHSVILLE RD",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175439133",
            "telephone_number": "717-556-0149",
            "fax_number": "717-556-0149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 W MAIN ST",
            "city": "LEOLA",
            "state": "PA",
            "postal_code": "175401753",
            "telephone_number": "717-556-0149",
            "fax_number": "717-556-0149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEMAN M CHAKARA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2013-07-02",
        "status": "A",
        "authorized_official_last_name": "CHAKARA",
        "authorized_official_first_name": "FREEMAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-556-0149",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "PA",
            "license": "PS009409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001897858",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "001334567",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02271001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY MEDICARE ASSURED",
            "identifier": "1548467",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "680015251",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leola, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.