KARISSA NICHOLE CHISUM PMHNP-BC
NPI 1558042101
Nurse Practitioner - Psychiatric/Mental Health in Costa Mesa, CA

Q: What is Karissa Chisum's NPI number?

The NPI number for Karissa Chisum is 1558042101. It was assigned to this individual provider in the NPPES registry on July 27, 2023.

Q: What is Karissa Chisum's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Karissa Chisum was last updated on May 24, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 27, 2023PECOS Enrolled

1640 NEWPORT BLVD STE 110, COSTA MESA, CA 92627(925) 282-1778 Get Directions Write a Review

NPPES record last updated: May 24, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

On this page

About Karissa Nichole Chisum Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KARISSA NICHOLE CHISUM PMHNP-BC (NPI 1558042101) is an individual psychiatric/mental health provider in Costa Mesa, California, licensed in California (95024718) and active in the NPI registry since July 2023. She is enrolled in Medicare PECOS and maintains a secondary practice location in Costa Mesa.

NPPES Registry Identity

NPI1558042101

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameKARISSA NICHOLE CHISUMCredential: PMHNP-BC

Location Address1640 NEWPORT BLVD STE 110Costa Mesa, CA 92627-7762

Mailing Address1640 Newport Blvd Ste 110Costa Mesa, CA 92627-7762

Phone(925) 282-1778

Sole ProprietorYes

Enumeration DateJuly 27, 2023

Last NPPES UpdateMay 24, 2024

NPPES CertifiedMay 24, 2024

✔ NPI 1558042101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in CA · 95024718

Also ListedRegistered NurseTaxonomy 163W00000X · License 95082085 (CA)

1640 NEWPORT BLVD STE 110, Costa Mesa, CA 92627

Open in Google Maps ↗

Secondary Practice Location 1

Location 12900 bristol st, building h, st 201costa mesa, CA 92626 · Phone (714) 617-7556

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Karissa Nichole Chisum Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92627 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Leave this field empty