CAROLYN JESSICA CHAN (DPT) – Physical Therapist, NPI 1023616901

CAROLYN JESSICA CHAN (DPT) is a healthcare provider. based in San diego, California. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. PT298690 (CA). The NPI Number for CAROLYN JESSICA CHAN (DPT) is 1023616901

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
CAROLYN JESSICA CHAN (DPT)
NPI
1023616901
Phone
(858) 264-1434
Address
3760 CONVOY ST STE 101
Enumeration Date
13 October 2020
Last Update Date
14 October 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8582700981
Graduation Year
2020 (6 years ago)
PAC ID
3274953716
Group Practice PAC ID
4981088994
Professional Enrollment ID
I20201021002312
Address ID
CA921175358SA3737XAVEX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

9,449 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CA

Provider Addresses for CAROLYN JESSICA CHAN (DPT)

  • 3760 CONVOY ST STE 101

    SAN DIEGO, CA 921113743

    Phone: (858) 264-1434

    Fax: (858) 751-0901

    Type: Mailing

  • 2115 MONTIEL RD STE 103

    SAN MARCOS, CA 920693587

    Phone: (760) 839-2905

    Fax: (760) 839-2901

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-10-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20201021002312IPhysical Therapist In Private PracticeCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97140Therapy procedure using manual technique, each 15 minutes64752$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes38049$0
97530Therapy procedure using functional activities29446$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes12032$0
97150Therapy procedure in a group setting9623$0
View full utilization report →

Insurance plans in this area (ZIP 92111)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4981088994View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeCA
Occupational Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Occupational Therapist In Private PracticeCA

Reviews

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Frequently asked questions

How is CAROLYN JESSICA CHAN (DPT) identified in CMS data?
CMS-hosted NPPES data lists CAROLYN JESSICA CHAN (DPT) with NPI 1023616901.
Does the file indicate CAROLYN JESSICA CHAN (DPT) is practicing under active NPI?
Directory data currently reports CAROLYN JESSICA CHAN (DPT) as active.
What is CAROLYN JESSICA CHAN (DPT)'s specialty?
The listing groups CAROLYN JESSICA CHAN (DPT) with Physical Therapist. Clinical services aligned with this taxonomy classification.
Where is CAROLYN JESSICA CHAN (DPT) based?
CAROLYN JESSICA CHAN (DPT) is tied to San Diego, California in the data we show; additional addresses may exist on the full record.
Why does CAROLYN JESSICA CHAN (DPT) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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