JESSICA DIANE CHISAM (CRNA) – Certified Registered Nurse Anesthetist, NPI 1265917280
Certified Registered Nurse Anesthetist
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Profile Insights
NPPES metrics only — not quality of care.
2,456 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in CA
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Provider Addresses for JESSICA DIANE CHISAM (CRNA)
6433 BATAAN ST
CYPRESS, CA 906305605
Phone: (562) 706-1830
Type: Mailing
5232, Hersholt Avenue, Lakewood, Los Angeles County, California, 90712, United States
LAKEWOOD, CA 907122733
Phone: (562) 706-1830
Type: Mailing
UCI Medical Center, 101, The City Drive South, Orange, Orange County, California, 92868, United States
ORANGE, CA 928683201
Phone: (714) 456-7890
Type: Location
PO BOX 512185
LOS ANGELES, CA 900510185
Phone:
Type: Mailing
1000 FIVEPOINT
IRVINE, CA 926182377
Phone: (800) 826-4673
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2018-11-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20181109002772 | I | Certified Registered Nurse Anesthetist (Crna) | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 90630)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | CA | |
| U R O L O G Y | CA | |
| G A S T R O E N T E R O L O G Y | CA | |
| U R O L O G Y | CA | |
| Urology, General Surgery | CA | |
| Gastroenterology, Internal Medicine | CA | |
| U R O L O G Y | CA | |
| G A S T R O E N T E R O L O G Y | CA | |
| - | CA | |
| G A S T R O E N T E R O L O G Y | CA |
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