Individual provider Active NPI

Chelsie Toni Buenviaje Gho, NP

  • Family Nurse Practitioner
  • Lakeport, CA
National Provider Identifier
1801635842
Registry record updated Jun 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95028071 Issued in CA
Practice address
987 Parallel Dr
Lakeport, CA 95453-5701
Phone
(707) 262-5088
NPI assigned
May 20, 2024
Last updated
Jun 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95028071 CA Primary

Addresses

Primary practice location

987 Parallel Dr
Lakeport, CA 95453-5701

Mailing address

33458 Whimbrel Rd
Fremont, CA 94555-1338
Phone (510) 579-6667

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
I20241115003488 CA Practitioner - Nurse Practitioner 6103350905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay HospitalsGroup PAC ID 3476506528, 45 clinicians
Sutter Lakeside Home Medical ServicesGroup PAC ID 1850338054, 19 clinicians

Practice addresses (Care Compare)

5176 Hill Rd E
Lakeport, CA 95453-6300
Phone (707) 262-5000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Hospitals CurrentSince Oct 16, 2024 Accepting new patients
Sutter Bay Hospitals Current Accepting new patients
Sutter Bay Hospitals CurrentSince Oct 16, 2024 Accepting new patients
Sutter Bay Hospitals PastSince May 26, 2024 Accepting new patients

Locations

5176 Hill Rd E
Lakeport, CA 95453
Phone (707) 262-5000

Interoperability endpoints

  • Direct secure messaging: cgho698229@hisp.ehr.sutterhealth.org

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.

Hospital & facility affiliations 1

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": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717200000000",
    "number": "1801635842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33458 WHIMBREL RD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945551338",
            "telephone_number": "510-579-6667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "987 PARALLEL DR",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954535701",
            "telephone_number": "707-262-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHO",
        "first_name": "CHELSIE TONI",
        "middle_name": "BUENVIAJE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-06-01",
        "certification_date": "2024-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95028071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeport, CA

Sources for this page

Verify at the official NPI Registry.