Karen G Chase, FNP RN

Individual provider Active NPI Nurse Practitioner · Fortuna, CA

NPI 1891729406 · NPPES record last updated Aug 22, 2014

Key facts

NPI
1891729406
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
FNP22744 (CA)
Practice address
3304 Renner Dr
Fortuna, CA 95540-7102
Phone
(707) 725-4477
Fax
(707) 725-9209
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 6

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 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
West Virginia University School of Medicine, 2002
Medicare assignment
May accept Medicare assignment
Group practices
Sutter Coast Hospital (29 clinicians)

Practice addresses (Care Compare)

780 E Washington Blvd
Crescent City, CA 95531-8397
Phone (707) 464-6715

800 E Washington Blvd
Crescent City, CA 95531-8359
Phone (707) 464-8511

Hospital & facility affiliations

  • Sutter Coast Hospital Hospital · Crescent City, CA · CCN 050417
  • Curry General Hospital Hospital · Gold Beach, OR · CCN 381322
  • Asante Rogue Regional Medical Center Hospital · Medford, OR · CCN 380018
  • California Pacific Medical Ctr-Davies Campus Hosp Hospital · San Francisco, CA · CCN 050008
  • Asante Three Rivers Medical Center Hospital · Grants Pass, OR · CCN 380002

Merit-based Incentive Payment System (MIPS)

Final score
82.99 of 100 (group)
Quality
57.99
Promoting interoperability
100
Improvement activities
40
Cost
72.95

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20181116000431 CA Practitioner - Nurse Practitioner 8820991755 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
1101505VAMDRegistered Nurse
FNP22744CAMDNurse Practitioner
0024165295VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Coast Hospital Current
since Sep 24, 2014
Accepting new patients
Sutter Coast Hospital Current
since Sep 24, 2014
Accepting new patients
Sutter Coast Hospital Past Accepting new patients

Locations

800 E Washington Blvd
Crescent City, CA 95531
Phone (707) 464-8511

780 E Washington Blvd
Crescent City, CA 95531
Phone (707) 464-5974

Interoperability endpoints

  • Direct secure messaging: kchase262226@hisp.ehr.sutterhealth.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1101505 VA
Nurse Practitioner 363L00000X 4066P KY
Family Nurse Practitioner 363LF0000X 0024165295 VA
Nurse Practitioner 363L00000X FNP22744 CA Yes

Addresses

Primary practice location

3304 Renner Dr
Fortuna, CA 95540-7102

Mailing address

670 9TH St
Suite 203
Arcata, CA 95521-6248
Phone (707) 826-8633

Other identifiers

IdentifierTypeStateIssuer
1891729406OtherCANATIONAL PROVIDER IDENTIFICATION
1510227MedicaidTN
1891729406MedicaidVA

Other providers in Fortuna, CA

All providers in Fortuna, CA · Nurse Practitioner in California

Sources for this page

Verify at the official NPI Registry.