Individual provider Active NPI

Charles Chaney, MD

  • Psychiatry Physician
  • Washington, DC
National Provider Identifier
1184990087
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD210002247 Issued in DC
Practice address
4228 Wisconsin Ave NW
Washington, DC 20016-2138
Phone
(202) 885-5600
NPI assigned
Mar 26, 2012
Last updated
Sep 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD210002247 DC Primary
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X A126814 CA

Addresses

Primary practice location

4228 Wisconsin Ave NW
Washington, DC 20016-2138

Mailing address

1601 Dove St Ste 185
Newport Beach, CA 92660-2441
Phone (949) 359-8010

Other practice location 1

301 Victoria St
Costa Mesa, CA 92627-1995
Phone (949) 642-2734

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171226001063 CA Practitioner - PsychiatryPractitioner - Pain Management 6305104209 Practice locations: Costa Mesa, CA

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.92 of 100Reported as group
Quality
75.35
Improvement activities
40
Cost
89.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A126814CAMDPain Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Source Medical, Inc. CurrentSince Nov 1, 2020 Accepting new patients

Locations

1601 Dove St
Ste 185
Newport Beach, CA 92660
Phone (949) 381-5720

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1184990087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 DOVE ST STE 185",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602441",
            "telephone_number": "949-359-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4228 WISCONSIN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162138",
            "telephone_number": "202-885-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Victoria St",
            "address_purpose": "LOCATION",
            "city": "Costa Mesa",
            "state": "CA",
            "postal_code": "926271995",
            "country_code": "US",
            "telephone_number": "949-642-2734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANEY",
        "first_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-26",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DC",
            "license": "MD210002247",
            "primary": true
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "CA",
            "license": "A126814",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.