Individual provider Active NPI

Sara Jean Chiulli, PT, DPT

  • Physical Therapist
  • Broomfield, CO
National Provider Identifier
1982931754
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 10456 Issued in CO
Practice address
11575 Main St
Suite 100
Broomfield, CO 80020-2780
Phone
(303) 467-2288
Fax
(303) 410-0100
NPI assigned
Nov 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 10456 CO Primary

Addresses

Primary practice location

11575 Main St
Suite 100
Broomfield, CO 80020-2780

Mailing address

275 S Main St
Ste 208
Longmont, CO 80501-6461
Phone (303) 776-3800

Other names 1

  • Sarah Jean Zajac Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100210000419 CO Practitioner - Physical Therapist in Private Practice 6305989575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Altitude Physical Therapy and Sports Medicine LLCGroup PAC ID 8628050267, 18 clinicians

Practice addresses (Care Compare)

275 S Main St
Suite 200
Longmont, CO 80501-6461
Phone (303) 776-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 10456COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Altitude Physical Therapy & Sports Medicine LLC CurrentSince Jan 24, 2021 Accepting new patients
Altitude Physical Therapy & Sports Medicine LLC Physical Therapist CurrentSince Jul 1, 2016 Accepting new patients

Locations

275 S Main St
Ste 208
Longmont, CO 80501
Phone (303) 776-3800

275 S Main St
Ste 200
Longmont, CO 80501

Organizations & group practices 2

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": "1258243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1982931754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 S MAIN ST",
            "address_2": "STE 208",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016461",
            "telephone_number": "303-776-3800",
            "fax_number": "303-776-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11575 MAIN ST",
            "address_2": "SUITE 100",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800202780",
            "telephone_number": "303-467-2288",
            "fax_number": "303-410-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIULLI",
        "first_name": "SARA",
        "middle_name": "JEAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-15",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PT 10456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "ZAJAC",
            "middle_name": "JEAN",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; 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.