NPIMap

Individual provider Active NPI

Nina C Chase-Bouamoud, P.A.-C

  • Medical Physician Assistant
  • Bullhead City, AZ
National Provider Identifier
1902012966
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5781 Issued in AZ
Practice address
2767 Silver Creek Rd
Bullhead City, AZ 86442-8227
Phone
(928) 704-6741
NPI assigned
May 15, 2007
Last updated
Oct 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5781 AZ Primary

Addresses

Primary practice location

2767 Silver Creek Rd
Bullhead City, AZ 86442-8227

Mailing address

2767 Silver Creek Rd Ste a
Bullhead City, AZ 86442-8227
Phone (928) 704-6741

Other identifiers 1

IdentifierTypeStateIssuer
5781OtherAZSTATE

Other names 1

  • Nina Chase Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20151207002153 AZ Practitioner - Physician Assistant 8123101078 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Drexel University College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Steven V Kozmary MD LLCGroup PAC ID 5294802831, 8 clinicians

Practice addresses (Care Compare)

2767 Silver Creek Rd
Suite a
Bullhead City, AZ 86442-8227
Phone (928) 704-6741

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
58.5
Improvement activities
40
Cost
72.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5781AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Steven V Kozmary MD LLC CurrentSince Oct 8, 2023 Accepting new patients
Hosea E Brown MD Inc Past Accepting new patients
Physician Providers Group PA PastSince Jul 9, 2023 Accepting new patients
Robert Ulseth LLC PastSince Dec 1, 2021 Accepting new patients

Locations

2767 Silver Creek Rd
Ste A
Bullhead City, AZ 86442
Phone (928) 542-9103

2851 El Camino Ave
Las Vegas, NV 89102
Phone (702) 380-3210

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1902012966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2767 SILVER CREEK RD STE A",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864428227",
            "telephone_number": "928-704-6741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2767 SILVER CREEK RD",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864428227",
            "telephone_number": "928-704-6741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHASE-BOUAMOUD",
        "first_name": "NINA",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "5781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "5781",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NINA",
            "last_name": "CHASE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bullhead City, AZ

Sources for this page

Verify at the official NPI Registry.