Karissa Nichole Chisum, PMHNP-BC in Costa Mesa, CA

Karissa Nichole Chisum, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Costa Mesa, California. Her current practice location is 1640 Newport Blvd Ste 110, Costa Mesa, California. You can reach out to her office (for appointments etc.) via phone at (925) 282-1778.

Karissa Nichole Chisum is licensed to practice in California (license number 95024718) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1558042101.

Contact Information

	Karissa Nichole Chisum, PMHNP-BC
	1640 Newport Blvd Ste 110, Costa Mesa, CA 92627-7762
	(925) 282-1778
	Not Available

Map and Direction

Provider's Profile

Full Name	Karissa Nichole Chisum
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	1640 Newport Blvd Ste 110, Costa Mesa, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1558042101
Provider Enumeration Date: 07/27/2023
Last Update Date: 05/24/2024

Medicare PECOS Information:

PECOS PAC ID: 1456893064
Enrollment ID: I20240611003143

Medical Identifiers

Medical identifiers for Karissa Nichole Chisum such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1558042101	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	95082085 (California)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	95024718 (California)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Karissa Nichole Chisum allows following entities to bill medicare on her behalf.

Entity Name	Pacific Coast Psychiatric Associates Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1023125465 PECOS PAC ID: 2567469174 Enrollment ID: O20061024000383

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Karissa Nichole Chisum is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Karissa Nichole Chisum, PMHNP-BC 1640 Newport Blvd Ste 110, Costa Mesa, CA 92627-7762 Ph: () -	Karissa Nichole Chisum, PMHNP-BC 1640 Newport Blvd Ste 110, Costa Mesa, CA 92627-7762 Ph: (925) 282-1778

Reviews and Comments

Nurse Practitioner Nurses in Costa Mesa, CA

Alexandra Hutchison, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1530 Baker St Ste A, Costa Mesa, CA 92626 Phone: 714-559-5436
Judith Rivera, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 600 Anton Blvd Fl 11, Costa Mesa, CA 92626 Phone: 623-374-7774 Fax: 855-420-6361
Madison Lucas, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 150 Paularino Ave Ste D182, Costa Mesa, CA 92626 Phone: 866-300-7227
Yvette Alfelor Elpidio, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3151 Airway Ave, T-3, Costa Mesa, CA 92626 Phone: 714-545-5550 Fax: 714-545-5748
Mrs. Suzanne Clara Larkin, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1665 Scenic Ave, Costa Mesa, CA 92626 Phone: 714-436-4444
Rachel Renee Cliser, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 188 E 17th St Ste 101, Costa Mesa, CA 92627 Phone: 949-515-4548
Courtney Proctor, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 601 W 19th St, Costa Mesa, CA 92627 Phone: 714-922-4100

Karissa Nichole Chisum, PMHNP-BC - Medicare Nurse Practitioner in Costa Mesa, CA