Carissa Leigh Chalut, D.O

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

OP61130040 Issued in WA

Practice address

1120 15TH St
Augusta, GA 30912-0004

Phone

(706) 721-2613

NPI assigned

Jun 23, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Emergency Medicine

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Olympia Emergency Services PLLCGroup PAC ID 9335035633, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cchalut@yourcarecommunity.org

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.

• Olympia Emergency Services, PLLC

  • Emergency Medicine Physician
  • Olympia, WA
  • NPI 1346267796
  Medicare reassignment Care Compare group NPD
• Northwest Emergency Physicians LLC

  • Emergency Medicine Physician
  • Arlington, WA
  • NPI 1235172370
  Medicare reassignment NPD
• Northwest Observation Associates PC

  • Internal Medicine Physician
  • Federal Way, WA
  • NPI 1023539376
  Medicare reassignment NPD
• Olympia Emergency Care Physicians PLLC

  • Emergency Medicine Physician
  • Olympia, WA
  • NPI 1396498671
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1346250594
  Care Compare affiliation
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1619176997
  Care Compare affiliation

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1801201413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-2613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHALUT",
        "first_name": "CARISSA",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-23",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "R9196",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "GA",
            "license": "6812",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "OP61130040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56647-95",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jan Pieters Ceyssens, PA
• Kathryn Anniemarie Ceyssens, OTR/L
• Wouter Johan Ceyssens, PA-C
• Amanda Chaffin
• Jihane Chaieb, PHARMD
• Lindsay Chambers, MPT
• Minnie Mallard Chambliss, PT
• Champions Clinical Services, LLC
• Alisha Chan
• Daniel C. N. Chan, DDS

• Emergency Medicine Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.

Verify at the official NPI Registry.