NPIMap

Organization Active NPI

Chuck R. Colas, D.O., P.C.

  • Family Medicine Physician
  • Cedarville, CA
National Provider Identifier
1861022873
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CHUCK R. COLAS, D.O., P.C.
Practice address
#66, County Rd. 37 #6
Cedarville, CA 96104
Phone
(314) 888-5233
Fax
(203) 590-8644
NPI assigned
Jan 17, 2020
Last updated
Jan 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Authorized official

Name
Dr. Kathleen Mary Berchelmann, M.D.NPI 1376565416
Title
President
Phone
(314) 435-6105

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

#66, County Rd. 37 #6
Cedarville, CA 96104

Mailing address

711 Silvermine Rd
New Canaan, CT 06840-4329
Phone (314) 888-5233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200505001484 CA Part B Supplier - Clinic/Group Practice 6204267305 Receives reassigned benefits from 3 practitioners
Practice locations: Hawthorne, CA; Seal Beach, CA

National Provider Directory

National Provider Directory

Locations

15720 Ventura Blvd
Ste 311
Encino, CA 91436
Phone (818) 906-3933

11901 Acacia Ave
Hawthorne, CA 90250

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579219200000",
    "number": "1861022873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 SILVERMINE RD",
            "city": "NEW CANAAN",
            "state": "CT",
            "postal_code": "068404329",
            "telephone_number": "314-888-5233",
            "fax_number": "203-590-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#66, COUNTY RD. 37 #6",
            "city": "CEDARVILLE",
            "state": "CA",
            "postal_code": "96104",
            "telephone_number": "314-888-5233",
            "fax_number": "203-590-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHUCK R. COLAS, D.O., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-17",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A",
        "authorized_official_last_name": "BERCHELMANN",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-435-6105",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedarville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.