Active NPI
Charistella Walter, NP
- Nurse Practitioner
- Santa Ana, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 95020949
- Practice address
- 201 Sandpointe Ave Ste 490
Santa Ana, CA 92707-6706 - Phone
- (714) 835-5477
- NPI assigned
- Jun 29, 2022
- Last updated
- Oct 28, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 95020949 | CA | Primary |
Addresses
Primary practice location
201 Sandpointe Ave Ste 490
Santa Ana, CA 92707-6706
Mailing address
201 Sandpointe Ave Ste 490
Santa Ana, CA 92707-6706
Phone (714) 835-5477
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
411 N Lakeview Ave
Anaheim, CA 92807-3028
Phone (714) 279-4000
5475 E la Palma Ave
Anaheim, CA 92807-2075
Phone (714) 279-6088
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| American Stellar Home Health Services Inc | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088
4760 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 783-0567
393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914
4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038
201 Sandpointe Ave
Ste 490
Santa Ana, CA 92707
Phone (714) 835-5477
2700 N Main St
Ste 506
Santa Ana, CA 92705
Phone (714) 972-2702
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Intellicare Home Health LLC | Home health agency | 5% Or Greater Direct Ownership Interest (33%) Corporate Officer Corporate Director W-2 Managing Employee |
Feb 16, 2024 Feb 16, 2024 Feb 16, 2024 Feb 16, 2024 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Home Health Agency
- Mission Viejo, CA
- NPI 1396501375
5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Home Health Agency
- Santa Ana, CA
- NPI 1538570106
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
dba Target Clinic Medical Associates of Southern California
- Health Maintenance Organization
- Fullerton, CA
- NPI 1336556059
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730073600000",
"number": "1598497323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 SANDPOINTE AVE STE 490",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927076706",
"telephone_number": "714-835-5477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 SANDPOINTE AVE STE 490",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927076706",
"telephone_number": "714-835-5477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTER",
"first_name": "CHARISTELLA",
"name_prefix": "Miss",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-29",
"last_updated": "2024-10-28",
"certification_date": "2024-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "95020949",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "4760 W Sunset Blvd",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900276063",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.