Individual provider Active NPI

Jessica N Chrisman, FNP

  • Family Nurse Practitioner
  • Camarillo, CA
National Provider Identifier
1700201258
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95000652 Issued in CA
Practice address
2486 N Ponderosa Dr Ste D114
Camarillo, CA 93010-2469
Phone
(805) 484-2783
Fax
(805) 987-8519
NPI assigned
Feb 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2266548 MA
Family Nurse Practitioner 363LF0000X 95000652 CA Primary

Addresses

Primary practice location

2486 N Ponderosa Dr Ste D114
Camarillo, CA 93010-2469

Mailing address

1310 Wellesley Ave Apt 206
Los Angeles, CA 90025-2097
Phone (508) 944-0587

Other practice location 1

795 Granite Street
Braintree, MA 02184
Phone (781) 848-1950

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
I20170622000627 CA Practitioner - Nurse Practitioner 5092083600 Reassigns benefits to 1 organization
Practice locations: Camarillo, CA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Monica Perlman MD IncGroup PAC ID 8820035884, 357 clinicians

Practice addresses (Care Compare)

3900 5TH Ave
Suite 110
San Diego, CA 92103-3122
Phone (858) 554-1212

Merit-based Incentive Payment System (MIPS)

Final score
92.17 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
73.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2266548MAMDNurse Practitioner
95000652CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Monica Perlman MD Inc. CurrentSince May 4, 2023 Accepting new patients
Cloud Health Medical Group of California, P.C. Past Accepting new patients
Chrysalis Health of Florida P.a. Past Accepting new patients
Regents of the University of California Past Accepting new patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients
Chrysalis Health of California, PC PastSince Jan 24, 2021 Accepting new patients

Locations

9850 Genesee Ave
Ste 320
La Jolla, CA 92037
Phone (858) 864-9800

3737 Moraga Ave
Ste B103
San Diego, CA 92117
Phone (858) 799-0855

3900 5th Ave
Ste 110
San Diego, CA 92103
Phone (619) 291-5474

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jessica.chrisman.2@19041.direct.athenahealth.com

Organizations & group practices 6

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": "1392854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1700201258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 WELLESLEY AVE APT 206",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252097",
            "telephone_number": "508-944-0587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2486 N PONDEROSA DR STE D114",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102469",
            "telephone_number": "805-484-2783",
            "fax_number": "805-987-8519"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "795 Granite Street",
            "address_purpose": "LOCATION",
            "city": "Braintree",
            "state": "MA",
            "postal_code": "02184",
            "country_code": "US",
            "telephone_number": "781-848-1950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISMAN",
        "first_name": "JESSICA",
        "middle_name": "N",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "2266548",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95000652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

Verify at the official NPI Registry.