NPIMap

Individual provider Active NPI

Carolyn Ruth Chase, RN, NP

  • Family Nurse Practitioner
  • Point Reyes Station, CA
National Provider Identifier
1811024599
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9465 Issued in CA
Practice address
3 Sixth St.
Point Reyes Station, CA 94956
Phone
(707) 559-7500
Fax
(707) 559-7707
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 515250 CA
Family Nurse Practitioner 363LF0000X 9465 CA Primary

Addresses

Primary practice location

3 Sixth St.
Point Reyes Station, CA 94956

Mailing address

1179 N McDowell Blvd
Petaluma, CA 94954-6559
Phone (707) 559-7500

Other practice location 1

11150 Highway 1
Point Reyes Station, CA 94956
Phone (415) 663-1082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250113003506 CA Order and Referring Only - Nurse Practitioner 3678755592

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Petaluma Health Center Inc 76 clinicians
Coastal Health Alliance 40 clinicians

Practice addresses (Care Compare)

1179 N McDowell Blvd
Petaluma, CA 94954-6559
Phone (707) 559-7500

5900 State Farm Dr
Suite 200
Rohnert Park, CA 94928-2149
Phone (707) 559-7600

PO Box
Suite 910
Point Reyes Station, CA 94956-0910

Hospital & facility affiliations

  • Sutter Care at Home Home health agency, Novato, CA, CCN 057031
  • Marinhealth Medical Center Hospital, Greenbrae, CA, CCN 050360
  • Novato Community Hospital Hospital, Novato, CA, CCN 050131
  • Petaluma Valley Hospital Hospital, Petaluma, CA, CCN 050136

Merit-based Incentive Payment System (MIPS)

Final score
91.9 of 100Reported as group
Quality
81.89
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
515250CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Petaluma Health Center Inc Past Accepting new patients
Petaluma Health Center Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cchase613965@direct.ochin.org

Organizations & group practices 8

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.

Hospital & facility affiliations 4

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1811024599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1179 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546559",
            "telephone_number": "707-559-7500",
            "fax_number": "707-559-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SIXTH ST.",
            "city": "POINT REYES STATION",
            "state": "CA",
            "postal_code": "94956",
            "telephone_number": "707-559-7500",
            "fax_number": "707-559-7707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11150 Highway 1",
            "address_purpose": "LOCATION",
            "city": "Point Reyes Station",
            "state": "CA",
            "postal_code": "94956",
            "country_code": "US",
            "telephone_number": "415-663-1082",
            "fax_number": "415-663-9474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHASE",
        "first_name": "CAROLYN",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "RN, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "515250",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "9465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Point Reyes Station, CA

Sources for this page

Verify at the official NPI Registry.