MR. JERRIN CHACKO PMHNP
NPI 1104593169
Nurse Practitioner - Psychiatric/Mental Health in Richmond Hill, NY
About Mr. Jerrin Chacko Pmhnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. JERRIN CHACKO PMHNP (NPI 1104593169) is an individual psychiatric/mental health provider in Richmond Hill, New York, licensed in New York (403669) and active in the NPI registry since August 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mr. Jerrin Chacko Pmhnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Jerrin Chacko reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
New Hyde Park, NY 11040
- Reassigned Medicare billing, New York enrollment
- 9,353 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 11418 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
RICHMOND HILL, NY 11418
RICHMOND HILL, NY 11418
RICHMOND HILL, NY 11418
JAMAICA, NY 11418
JAMAICA, NY 11418
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jerrin Chacko's NPI number?
The NPI number for Jerrin Chacko is 1104593169. It was assigned to this individual provider in the NPPES registry on August 26, 2021.
Where is Jerrin Chacko located?
Jerrin Chacko practices at 8900 Van Wyck Expy, Richmond Hill, NY 11418. The listed phone number is (718) 206-6000.
What is Jerrin Chacko's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Jerrin Chacko enrolled in Medicare?
Yes. Jerrin Chacko is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Jerrin Chacko's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jerrin Chacko reassigns Medicare benefits to North Shore - Lij Medical PC (New Hyde Park, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jerrin Chacko's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jerrin Chacko was last updated on August 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mr. Jerrin Chacko, PMHNP · NPI 1104593169
Psychiatric/Mental Health physician in Richmond Hill, New York. Individual provider, active in the CMS NPPES registry since August 26, 2021.
## Identity
- **NPI:** 1104593169 (Entity type: Individual)
- **Enumerated:** August 26, 2021
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 403669 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 8900 VAN WYCK EXPY, Richmond Hill, NY 11418-2832
- **Phone:** (718) 206-6000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** North Shore - Lij Medical PC (NPI 1790043479, New Hyde Park, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** August 26, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1104593169) · Data from the CMS NPPES public registry.