Individual provider Active NPI

Hannah Chae

  • Physician Assistant
  • Sherman Oaks, CA
National Provider Identifier
1417522798
Registry record updated Sep 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA63257 Issued in CA
Practice address
5805 Sepulveda Blvd Ste 690
Sherman Oaks, CA 91411-2522
Phone
(818) 900-6480
NPI assigned
May 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA63257 CA Primary

Addresses

Primary practice location

5805 Sepulveda Blvd Ste 690
Sherman Oaks, CA 91411-2522

Mailing address

5805 Sepulveda Blvd Ste 690
Sherman Oaks, CA 91411-2522
Phone (818) 900-6480

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231010001522 CA Practitioner - Physician Assistant 7719332816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Multi-Specialty Center IncGroup PAC ID 4082953336, 16 clinicians

Practice addresses (Care Compare)

19950 Rinaldi St
Suite 101D
Porter Ranch, CA 91326-4254
Phone (818) 900-6480

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA63257CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Multi-Specialty Center Inc CurrentSince Aug 25, 2023 Accepting new patients

Locations

19950 Rinaldi St
Ste 101D
Porter Ranch, CA 91326
Phone (818) 488-5188

5805 Sepulveda Blvd
Ste 690
Van Nuys, CA 91411
Phone (818) 900-6480

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693785600000",
    "number": "1417522798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5805 SEPULVEDA BLVD STE 690",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914112522",
            "telephone_number": "818-900-6480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5805 SEPULVEDA BLVD STE 690",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914112522",
            "telephone_number": "818-900-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAE",
        "first_name": "HANNAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2023-09-04",
        "certification_date": "2023-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA63257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.