Kathleen A Chase, DO
Individual provider Active NPI Family Medicine Physician · Marina, CA
NPI 1407004591 · NPPES record last updated Nov 12, 2020
Key facts
- NPI
- 1407004591
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 20A18566 (CA)
- Practice address
- 2930 2ND Ave Ste 200
Marina, CA 93933-6244 - Phone
- (831) 582-2100
- Fax
- (831) 886-1529
- NPI assigned
- Sep 3, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Touro Un College of Osteopathic Medicine, Vallejo, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Montage Medical Group
Practice addresses (Care Compare)
2930 2ND Ave
Suite 200
Marina, CA 93933-6244
Phone (831) 582-2100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201119001796 | CA | Practitioner - Family Practice | 2365596715 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A18566 | CA | MD | Family Medicine Physician |
| 47853 | CO | MD | Family Medicine Physician |
| OS10174 | FL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montage Medical Group | Current |
Accepting new patients |
Locations
2930 2nd Ave
#200
Marina, CA 93933
Phone (831) 582-2100
2930 2nd Ave
Ste 200
Marina, CA 93933
Phone (831) 532-2100
100 Wilson Rd
Ste 100
Monterey, CA 93940
Phone (831) 242-8301
23845 Holman Hwy
Ste 210
Monterey, CA 93940
Phone (831) 620-0296
2 Upper Ragsdale Dr
Bldg A
Monterey, CA 93940
Phone (831) 333-3040
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OS10174 | FL | |
| Family Medicine Physician | 207Q00000X | 47853 | CO | |
| Family Medicine Physician | 207Q00000X | 20A18566 | CA | Yes |
Addresses
Primary practice location
2930 2ND Ave Ste 200
Marina, CA 93933-6244
Mailing address
2930 2ND Ave Ste 200
Marina, CA 93933-6244
Phone (831) 582-2100
Other practice location 1
2 Upper Ragsdale Dr Bldg A
Monterey, CA 93940-5736
Phone (831) 333-3040
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020252 | Other | CO | KAISER COMMERCIAL NUMBER |
| 68587244 | Medicaid | CO |
Other names
- Dr. Kathleen McGrath
Other providers in Marina, CA
- Brittany Castillo
- Stephanie Cazarez
- Victoria Cervantes
- Wesley Chan
- Nancy W Chang
- Gisselle Chavez
- Sana Chawla
- Weiwei Chen
- Marjorie Danielle Chiala
- Mary Chick
All providers in Marina, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.