Individual provider Active NPI

Christine Louise Tanous

  • Family Nurse Practitioner
  • Pismo Beach, CA
National Provider Identifier
1982479556
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95027517 Issued in CA
Practice address
901 Oak Park Blvd Ste 101
Pismo Beach, CA 93449-3409
Phone
(805) 481-2205
Fax
(805) 481-2206
NPI assigned
Nov 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95027517 CA Primary

Addresses

Primary practice location

901 Oak Park Blvd Ste 101
Pismo Beach, CA 93449-3409

Mailing address

901 Oak Park Blvd Ste 101
Pismo Beach, CA 93449-3409
Phone (805) 481-2205

Other names 1

  • Christine Louise Kisch Former name

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231227003098 CA Practitioner - Nurse Practitioner 7416307814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

901 Oak Park Blvd
Suite 101
Pismo Beach, CA 93449-3409
Phone (805) 481-2205

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Central Coast Health Centers CurrentSince Feb 5, 2024 Accepting new patients
Pacific Central Coast Health Centers Current Accepting new patients
Pacific Central Coast Health Centers CurrentSince Feb 5, 2024 Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients

Locations

500 Old River Rd
Ste 200
Bakersfield, CA 93311
Phone (661) 663-6429

2901 N Ventura Rd
Ste 110
Oxnard, CA 93036
Phone (805) 981-6163

901 Oak Park Blvd
Pismo Beach, CA 93449
Phone (805) 489-2205

901 Oak Park Blvd
Ste 101
Pismo Beach, CA 93449
Phone (805) 481-2205

1414 E Main St
Ste 201
Santa Maria, CA 93454
Phone (805) 739-3112

117 W Bunny Ave
Santa Maria, CA 93458
Phone (805) 739-3474

1510 E Main St
Ste 104C
Santa Maria, CA 93454
Phone (805) 349-8514

Organizations & group practices 4

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 2

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": "1700697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1982479556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 OAK PARK BLVD STE 101",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493409",
            "telephone_number": "805-481-2205",
            "fax_number": "805-481-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 OAK PARK BLVD STE 101",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493409",
            "telephone_number": "805-481-2205",
            "fax_number": "805-481-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANOUS",
        "first_name": "CHRISTINE",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-23",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95027517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "KISCH",
            "middle_name": "LOUISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pismo Beach, CA

Sources for this page

Verify at the official NPI Registry.