Carissa A Dahl

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

AP60932540 Issued in WA

Practice address

716 E Manitoba Ave
Ellensburg, WA 98926-3842

Phone

(509) 933-8777

NPI assigned

Feb 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kittitas County Public Hospital Dist 1Group PAC ID 0547179608, 82 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kittitas Valley Home Health & Hospice Home health agency, Ellensburg, WA, CCN 507097
• Kittitas Valley Community Hospital Hospital, Ellensburg, WA, CCN 501333
• Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036
• Swedish Issaquah Hospital, Issaquah, WA, CCN 500152

Merit-based Incentive Payment System (MIPS)

Final score

80.91 of 100Reported as group

Quality

66.6

Promoting interoperability

100

Improvement activities

40

Cost

69.77

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

• Kittitas County Public Hospital Dist 1

  • Critical Access Hospital
  • Ellensburg, WA
  • NPI 1356375307

  WA

  Medicare reassignment Care Compare group NPD
• Kittitas County Public Hospital Dist 1

  • Rural Health Clinic/Center
  • Ellensburg, WA
  • NPI 1932115391
  Care Compare group NPD (past)
• Kittitas County Public Hospital Dist 1

  • Rehabilitation Hospital Unit
  • Ellensburg, WA
  • NPI 1033139431
  Care Compare group
• Kittitas County Public Hospital Dist 1

  • Rural Health Clinic/Center
  • Cle Elum, WA
  • NPI 1194747774
  Care Compare group
• Kittitas County Public Hospital Dist 1

  • Home Health Agency
  • Ellensburg, WA
  • NPI 1376561654
  Care Compare group
• Kittitas County Public Hospital Dist 1

  • Community Based Hospice Care Agency
  • Ellensburg, WA
  • NPI 1639197882
  Care Compare group
• Kittitas County Public Hospital Dist 1

  • Rural Health Clinic/Center
  • Ellensburg, WA
  • NPI 1770711764
  Care Compare group
• Kittitas County Public Hosp Dist 1

  • Specialist
  • Ellensburg, WA
  • NPI 1376773002
  NPD
• Kittitas County Public Hosp Dist 1

  • Urology Physician
  • Ellensburg, WA
  • NPI 1437029832
  NPD

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

• Kittitas County Public Hospital Dist 1

  • Critical Access Hospital
  • Ellensburg, WA
  • NPI 1356375307

  Hospital

  Care Compare affiliation
• Kittitas County Public Hospital Dist 1

  • Home Health Agency
  • Ellensburg, WA
  • NPI 1376561654
  Care Compare affiliation
• Swedish Health Services

  • General Acute Care Hospital
  • Issaquah, WA
  • NPI 1851686059

  Hospital

  Care Compare affiliation
• Yakima Valley Memorial Hospital Association

  • General Acute Care Hospital
  • Yakima, WA
  • NPI 1053373480

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1356808596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 E MANITOBA AVE",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263842",
            "telephone_number": "509-933-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 E MANITOBA AVE",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263842",
            "telephone_number": "509-933-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHL",
        "first_name": "CARISSA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-25",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "AP60932540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Ellensburg, WA
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.