NPIMap

Individual provider Active NPI

Evan Chisum, MD

  • Emergency Medicine Physician
  • Sacramento, CA
National Provider Identifier
1811037716
Registry record updated Jun 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A78813 Issued in CA
Practice address
4001 J St
Sacramento, CA 95819-3626
Phone
(330) 493-4443
NPI assigned
Feb 8, 2007
Last updated
Jun 20, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A78813 CA Primary

Addresses

Primary practice location

4001 J St
Sacramento, CA 95819-3626

Mailing address

150 Cashman Cir
Sacramento, CA 95835-1606
Phone (916) 419-8841

Other identifiers 1

IdentifierTypeStateIssuer
00A788130MedicaidCA

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
I20090728000778 CA Practitioner - Emergency Medicine 5395898019 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, Davis School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity Emergency PhysiciansGroup PAC ID 4284171166, 47 clinicians
Pacific Redwood Medical Group IncGroup PAC ID 5496652703, 58 clinicians

Practice addresses (Care Compare)

1100 Butte St
Redding, CA 96001-0852
Phone (530) 244-5400

15630 18TH Ave
Clearlake, CA 95422-9336
Phone (701) 994-6486

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.74 of 100Reported as group
Quality
94
Promoting interoperability
92
Improvement activities
40
Cost
65.12

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
94.76
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Redwood Medical Group Inc Emergency Medicine CurrentSince Oct 1, 2022 Accepting new patients
Erx Plus Professional Corporation Emergency Medicine CurrentSince Feb 1, 2023 Accepting new patients
Team Physicians of California Medical Group Inc Emergency Medicine CurrentSince Feb 1, 2023 Accepting new patients
Trinity Emergency Physicians Emergency Medicine CurrentSince Sep 25, 2025 Accepting new patients
Erx Hospitalist Group PC CurrentSince Feb 1, 2023 Accepting new patients
Erx Plus Professional Corporation Emergency Medicine Past Accepting new patients
Emergency Medicine Physician Partners of Calaveras County, Inc Emergency Medicine Past Accepting new patients
Urgent Care Center of Folsom Past Accepting new patients
Acute Medical Providers - Inpatient Inc. Past Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients
Sutter East Bay Medical Foundation Emergency Medicine Past Accepting new patients

Locations

15630 18th Ave
Clearlake, CA 95422
Phone (707) 995-5820

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

5189 Hospital Rd
Mariposa, CA 95338
Phone (209) 966-3631

1100 Butte St
Redding, CA 96001
Phone (530) 227-6361

10 Woodland Rd
Saint Helena, CA 94574
Phone (707) 261-7821

525 W Acacia St
Stockton, CA 95203
Phone (209) 944-5410

275 Hospital Dr
Ukiah, CA 95482
Phone (707) 462-7900

2000 N Classen Blvd
Ste 1200
Oklahoma City, OK 73106
Phone (866) 488-4558

Organizations & group practices 12

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 3

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371686400000",
    "number": "1811037716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 CASHMAN CIR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958351606",
            "telephone_number": "916-419-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 J ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193626",
            "telephone_number": "330-493-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISUM",
        "first_name": "EVAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2013-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A78813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A788130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.