Individual provider Active NPI

Robert A Chase, M.D.

  • Otolaryngology Physician
  • Placerville, CA
National Provider Identifier
1487757779
Registry record updated Jan 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
G74828 Issued in CA
Practice address
4300 Golden Center Dr
Suite D
Placerville, CA 95667-6278
Phone
(530) 344-2000
Fax
(530) 344-2014
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X G74828 CA
Otolaryngology Physician 207Y00000X G74828 CA Primary

Addresses

Primary practice location

4300 Golden Center Dr
Suite D
Placerville, CA 95667-6278

Mailing address

PO Box 45680
San Francisco, CA 94145-0680
Phone (530) 344-2000

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
I20070626000293 CA Practitioner - Otolaryngology 8224042759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
State University of New York Downstate Medical Center, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marshall Medical Center 168 clinicians

Practice addresses (Care Compare)

4300 Golden Ctr Dr
Suite D
Placerville, CA 95667-6278
Phone (530) 344-2000

Hospital & facility affiliations

  • Marshall Medical Center Hospital, Placerville, CA, CCN 050254
  • University of California Davis Medical Center Hospital, Sacramento, CA, CCN 050599

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G74828CAMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall Medical Center CurrentSince Apr 1, 2016 Accepting new patients
Marshall Medical Center CurrentSince Apr 1, 2016 Accepting new patients
Marshall Medical Center Past Accepting new patients
Marshall Medical Center Past Accepting new patients

Locations

3581 Palmer Dr
Ste 602
Cameron Park, CA 95682
Phone (530) 626-2920

1004 Fowler Way
Ste 4
Placerville, CA 95667
Phone (530) 626-9488

4300 Golden Center Dr
Ste D
Placerville, CA 95667
Phone (530) 344-2000

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1487757779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45680",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941450680",
            "telephone_number": "530-344-2000",
            "fax_number": "530-344-2014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 GOLDEN CENTER DR",
            "address_2": "SUITE D",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676278",
            "telephone_number": "530-344-2000",
            "fax_number": "530-344-2014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHASE",
        "first_name": "ROBERT",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "G74828",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G74828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

Verify at the official NPI Registry.