Individual provider Active NPI

Karynne F. Ednacot, FNP-C

  • Nurse Practitioner
  • Chula Vista, CA
National Provider Identifier
1548027964
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95021633 Issued in CA
Practice address
416 Broadway
Chula Vista, CA 91910-4304
Phone
(619) 427-1144
Fax
(619) 427-1185
NPI assigned
Mar 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95021633 CA Primary

Addresses

Primary practice location

416 Broadway
Chula Vista, CA 91910-4304

Mailing address

9373 Hazard Way Ste 200
San Diego, CA 92123-1226
Phone (858) 810-8000

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
I20240403002205 CA Practitioner - Nurse Practitioner 8325486848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4225 Executive SQ
Suite 450
La Jolla, CA 92037-8411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95021633CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Balboa Nephrology Medical Group, Inc. Nephrology CurrentSince Apr 15, 2024 Accepting new patients
Balboa Nephrology Medical Group,Inc. CurrentSince Apr 15, 2024 Accepting new patients

Locations

340 Fourth Ave
Ste 4
Chula Vista, CA 91910
Phone (619) 422-0145

4225 Executive Sq
Ste 450
La Jolla, CA 92037
Phone (858) 810-8000

3300 Vista Way
Ste B
Oceanside, CA 92056
Phone (760) 967-9569

8010 Frost St
Ste 100
San Diego, CA 92123
Phone (858) 637-4700

4060 4th Ave
Ste 220
San Diego, CA 92103
Phone (619) 299-2350

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kednacot63443@direct.acumenmd.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1548027964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9373 HAZARD WAY STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231226",
            "telephone_number": "858-810-8000",
            "fax_number": "858-268-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 BROADWAY",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104304",
            "telephone_number": "619-427-1144",
            "fax_number": "619-427-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDNACOT",
        "first_name": "KARYNNE",
        "middle_name": "F.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-04",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95021633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.