Look up the most recent NPI and PECOS records

Brian Chaballa

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Brian Chaballa is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1285434449
Provider Type
Individual
Full Name
Chaballa, Brian
Title
Mr.
Credential
PA-C

Gender
Male
Sole Proprietor
No
Enumeration Date
3/17/2025
Last Updated
4/14/2025

Contact Information

Practice Location

19 Davis Ave, Fl 2, Neptune, NJ 07753

(732) 776-4135

Unlisted Fax

Mailing Location

331 Newman Springs Rd, Bldg 2, Ste 220, Red Bank, NJ 07701-5688

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 25MP00917900 New Jersey
Code 363AS0400X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 25MP00917900 New Jersey

Brian Chaballa

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Van Nest, Justin

Digiorgio, Tiffany Marie

Carr, Kristin K.

Costanzo, Samantha Leigh

Knee, Marissa

Rulka, Kyle

Calavetta, Barbara A

Edwards, Deanna

Sawyers, Katrina M

Khan, Haroon M