Clara Chae, M.D

Primary specialty

Obstetrics PhysicianTaxonomy code 207VX0000X

License

128817 Issued in CA

Practice address

4646 Brockton Ave Ste 201
Riverside, CA 92506-0104

Phone

(951) 585-1800

Fax

(951) 585-1801

NPI assigned

Jun 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: clara.chae@662570498326532.direct.elationemr.com

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.

• Altais Medical Group - Riverside, Inc.

  • Family Medicine Physician
  • Riverside, CA
  • NPI 1518629575
  Medicare reassignment NPD
• Amg, a Professional Medical Corporation

  • Internal Medicine Physician
  • Alhambra, CA
  • NPI 1558306266
  Medicare reassignment NPD
• Riverside Medical Clinic, Inc

  • Sports Medicine (Family Medicine) Physician
  • Riverside, CA
  • NPI 1316080880

  Obstetrics & Gynecology

  NPD (past)

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1861697427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6250 CLAY ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925096005",
            "telephone_number": "951-360-5265",
            "fax_number": "951-360-6276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 BROCKTON AVE STE 201",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925060104",
            "telephone_number": "951-585-1800",
            "fax_number": "951-585-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAE",
        "first_name": "CLARA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "35095607",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "CA",
            "license": "128817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "4304441",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SITE PTAN",
            "identifier": "1639274319",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "ZZZ31887Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3103368",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephani Marie Cerverizzo-Sanford
• Theresa M. Cervinski, O.D.
• Carolina Cesena, AMFT,APCC
• Adair Chacon
• Andrea Chacon
• Jin Chae, M.D.
• Sarah Chae, MD
• Balinder Kaur Chahal, RN
• Fiona Chai-Tom, DO
• Verania Chaidez Lopez, BA

• Obstetrics Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Obstetrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.