MYSTY CHACKO (NPI# 1669003745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1669003745 |
Entity Type | Individual |
Full Name | MYSTY CHACKO |
Credential | PA-C |
Practice Address |
132 S 10th St Philadelphia PA 19107-5244 |
Mailing Address |
132 S 10th Street 480 Main Building Phila PA 19107 |
Practice Telephone | 2159558900 |
Mailing Telephone | 2159558900 |
Mailing Fax Number | 2159555245 |
Enumeration Date | 2020-01-28 |
Last Update Date | 2020-02-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
MA061392 | PA | Allopathic & Osteopathic Physicians |
Address | Telephone Number | Fax Number |
---|---|---|
132 S 10th St, Philadelphia, PA 191075244 | 8005333669 |
Street Address |
132 S 10TH ST |
City | PHILADELPHIA |
State | PA |
Zip Code | 19107-5244 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275521353 | Charalambos C Solomides | Pathology | 132 S 10th St, Main Building 285k, Philadelphia, PA 19107-5244 | 2005-10-12 |
1801430228 | Kimberly Irene Ward | Physician Assistant | 132 S 10th St, Philadelphia, PA 19107-5244 | 2019-10-29 |
1316597073 | Alyssa Angradi | Physician Assistant | 132 S 10th St, Philadelphia, PA 19107-5244 | 2019-09-16 |
1790335412 | Sarah Alexandra Ackerman | Nurse Practitioner | 132 S 10th St, Philadelphia, PA 19107-5244 | 2019-09-14 |
1972150399 | Danielle Marotta | Nurse Practitioner | 132 S 10th St, Philadelphia, PA 19107-5244 | 2019-08-21 |
1649825795 | Methodist Associates In Healthcare, Inc. | Internal Medicine | 132 S 10th St, Philadelphia, PA 19107-5244 | 2019-08-06 |
1023672029 | Rahed Mohammed | Student in an Organized Health Care Education/Training Program | 132 S 10th St, Philadelphia, PA 19107-5244 | 2019-04-24 |
1265095889 | Ryan Matthew Sutton | Student in an Organized Health Care Education/Training Program | 132 S 10th St, Philadelphia, PA 19107-5244 | 2019-04-18 |
1821551706 | Jason Ho | Student in an Organized Health Care Education/Training Program | 132 S 10th St, Philadelphia, PA 19107-5244 | 2019-04-09 |
1144784059 | Mary Szymanski | Nurse Practitioner | 132 S 10th St, Philadelphia, PA 19107-5244 | 2019-01-24 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578170940 | Stephanie Quist | Pharmacist | 1 S Broad Street, Philadelphia, PA 19107 | 2020-09-29 |
1457968448 | Cloudline Physical Therapy LLC | Physical Therapist | 239-241 South 10th St, Philadelphia, PA 19107 | 2020-09-24 |
1053931303 | Wilson Wong | Pharmacist | Cvs Pharmacy #450, 3401 Walnut St, Philadelphia, PA 19107 | 2020-04-16 |
1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
1639632185 | Taylor D'amore | Orthopaedic Surgery | 925 Chest Street 5th Floor, Philadelphia, PA 19107 | 2019-04-11 |
1043779630 | Heather Lynn Yenser | Nurse Practitioner | 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 | 2019-03-14 |
1174093702 | Jennifer Lynn Kengeter | Psychologist | 900 Walnut Street, Suite 200, Philadelphia, PA 19107 | 2018-11-27 |
1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
1922588623 | Hyung Bin Lee | Dentist | 315 N 12th St, Apt 803, Philadelphia, PA 19107 | 2018-08-21 |
1750860490 | Anastasiya Khlypnych | Physician Assistant | 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 | 2018-08-13 |
Find all providers in zip 19107 |
Taxonomy Code | 207RG0100X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Gastroenterology |
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013150796 | Richard Mao Wu | Internal Medicine | 132 S. 10th Street, Main Bldg, Ste 430, Philadelphia, PA 19107 | 2009-04-11 |
1811148430 | Kian Makipour | Internal Medicine | 3401 North Broad St, Philadelphia, PA 19130 | 2008-10-01 |
1982865127 | Shivan Jatin Mehta | Internal Medicine | 423 Guardian Dr, Blockley Hall 1137, Philadelphia, PA 19104-4865 | 2008-06-20 |
1730204355 | Rahul Anand Nathwani | Internal Medicine | 132 S 10th St Ste 480, Philadelphia, PA 19107-5244 | 2007-03-20 |
1386729705 | Blake Gastroenterology Associates, LLC | Internal Medicine | 6827-31 Germantown Ave, Philadelphia, PA 19119-2113 | 2006-10-25 |
1942393830 | John Patrick Lynch | Internal Medicine | 415 Curie Blvd, 600 Crb, Philadelphia, PA 19104-4306 | 2006-10-02 |
1962428433 | Keith Joseph Buhl | Internal Medicine | 1403 Rhawn Street, Philadelphia, PA 19111-2430 | 2006-07-15 |
1366476020 | Michael J Rosner | Internal Medicine | 4242 Cottman Ave, Philadelphia, PA 19135-1118 | 2006-07-10 |
1558300152 | Xiaoli Ma | Internal Medicine | 121 N 9th St, Philadelphia, PA 19107-2410 | 2006-06-06 |
1275571945 | Oleg Volchonok | Internal Medicine | 11400 Bustleton Ave, Philadelphia, PA 19116-2815 | 2006-06-03 |
Find all providers in PHILADELPHIA |
City | PHILADELPHIA |
Zip Code | 19107 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.