Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mysty Chacko, PA-C

Individual provider Gastroenterology Physician · NPI 1669003745

Mysty Chacko, PA-C is a Physician Assistant in Moorestown, New Jersey. Qualified in 2019, 7 years ago. Practices with Cmc Department of Medicine Group PA, a 474-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New Jersey and Pennsylvania.

Years since qualifying
7
Licensed in
NJ, PA
In the registry since
2020
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

400 W Route 38
Moorestown, NJ 08057-3219
Phone: (856) 270-4000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 132 S 10th St, Philadelphia, PA 19107-5244 — (215) 955-8900

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 25MP00866300 (NJ)
Gastroenterology Physician Taxonomy 207RG0100X · Licence MA061392 (PA)

Record details

NPI number1669003745
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 28, 2020
Last updated in NPPESAugust 7, 2024
Certification dateAugust 7, 2024
Mailing address1 Federal St Ste 200, Camden, NJ 08103-1088

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Cmc Department Of Medicine Group Pa — 474 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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