NPIMap

Individual provider Active NPI

Christopher J Charbonnet, M.D.

  • Interventional Pain Medicine Physician
  • Glendale, CA
National Provider Identifier
1225049968
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
G79131 Issued in CA
Practice address
1530 E Chevy Chase Dr
Suite 204
Glendale, CA 91206-4163
Phone
(818) 241-7246
Fax
(818) 241-1639
NPI assigned
Aug 10, 2006
Last updated
Oct 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G79131 CA
Pain Medicine Physician 208VP0000X G79131 CA
Interventional Pain Medicine Physician 208VP0014X G79131 CA Primary

Addresses

Primary practice location

1530 E Chevy Chase Dr
Suite 204
Glendale, CA 91206-4163

Mailing address

PO Box 5486
Orange, CA 92863-5486
Phone (818) 550-0900

Other identifiers 2

IdentifierTypeStateIssuer
00G791310OtherCABLUE SHIELD
00G791310MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040512001677 CA Practitioner - Interventional Pain ManagementPractitioner - Anesthesiology 5496745481 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Anesthesiology
Education
University of Southern California Keck School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Westlake Pain Management Medical Associates IncGroup PAC ID 3173511748, 4 clinicians

Practice addresses (Care Compare)

1500 E Chevy Chase Dr
Suite 201
Glendale, CA 91206-4199
Phone (818) 863-4099

1500 E Chevy Chase Dr
Suite 401
Glendale, CA 91206-4191
Phone (818) 863-4446

1530 E Chevy Chase Dr
Suite 204
Glendale, CA 91206-4139
Phone (818) 241-7246

7624 Painter Ave
Suite 202
Whittier, CA 90602-2390
Phone (562) 696-5441

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
78.77
Promoting interoperability
92
Improvement activities
40
Cost
48

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Glendale Adventist Medical Center Interventional Pain Medicine CurrentSince Aug 19, 2012 Accepting new patients
Christopher J. Charbonnet, M.D., a Professional Corporation Interventional Pain Medicine CurrentSince Jan 1, 2008 Accepting new patients
Glendale Adventist Medical Center Interventional Pain Medicine CurrentSince Aug 19, 2012 Accepting new patients
Westlake Pain Management Medical Associates Inc. Pain Medicine CurrentSince Feb 22, 2004 Accepting new patients
Dignity Health Interventional Pain Medicine Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
White Memorial Medical Center Interventional Pain Medicine Past Accepting new patients
Pih Health Downey Hospital Interventional Pain Medicine PastSince Feb 22, 2004 Accepting new patients
John G Olea, MD Apc Anesthesiology Past Accepting new patients

Locations

11411 Brookshire Ave
Ste 205
Downey, CA 90241
Phone (562) 622-0095

8067 Florence Ave
Downey, CA 90240
Phone (562) 622-0095

1500 E Chevy Chase Dr
Ste 201
Glendale, CA 91206
Phone (818) 863-4099

1509 Wilson Ter
Glendale, CA 91206
Phone (818) 409-8071

1530 E Chevy Chase Dr
Ste 204
Glendale, CA 91206
Phone (818) 241-7246

300 S 5th St
Ste B
Oxnard, CA 93030
Phone (866) 282-8387

520 N Prospect Ave
Ste 307
Redondo Beach, CA 90277
Phone (310) 374-3500

7624 Painter Ave
Ste 202
Whittier, CA 90602
Phone (310) 374-3500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: christopher.charbonnet@4068.securemail.prognocis.com

Organizations & group practices 9

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1225049968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5486",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928635486",
            "telephone_number": "818-550-0900",
            "fax_number": "505-293-1524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 E CHEVY CHASE DR",
            "address_2": "SUITE 204",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064163",
            "telephone_number": "818-241-7246",
            "fax_number": "818-241-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARBONNET",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G79131",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "G79131",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "G79131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G791310",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G791310",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.