Iryna Kinzer, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA55507 Issued in CA

Practice address

255 Terracina Blvd Ste 205C
Redlands, CA 92373-4870

Phone

(909) 793-2323

Fax

(909) 793-2324

NPI assigned

Jan 17, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Iryna Khlebnikava Former name

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Dermatology InstituteGroup PAC ID 2062546260, 32 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Pacific Dermatology Institute

  • Dermatology Physician
  • Corona, CA
  • NPI 1740410182
  Medicare reassignment Care Compare group
• Loma Linda University Medical Center

  • General Acute Care Hospital
  • Loma Linda, CA
  • NPI 1194731935
  NPD (past)
• Pomona Valley Hospital Medical Center

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1518067586
  NPD (past)
• Redlands Community Hospital

  • General Acute Care Hospital
  • Redlands, CA
  • NPI 1043354111
  NPD (past)
• San Gorgonio Memorial Hospital

  • General Acute Care Hospital
  • Banning, CA
  • NPI 1568469997
  NPD (past)
• Uhs Corona Inc

  • Rehabilitation Hospital Unit
  • Corona, CA
  • NPI 1255327920
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1003380593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 534",
            "city": "LAKE ARROWHEAD",
            "state": "CA",
            "postal_code": "923520534",
            "telephone_number": "909-503-2311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 TERRACINA BLVD STE 205C",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734870",
            "telephone_number": "909-793-2323",
            "fax_number": "909-793-2324"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11340 Mountain View Ave Ste B1",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923543884",
            "country_code": "US",
            "telephone_number": "909-918-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25405 Hancock Ave Ste 217",
            "address_purpose": "LOCATION",
            "city": "Murrieta",
            "state": "CA",
            "postal_code": "925625978",
            "country_code": "US",
            "telephone_number": "951-200-2090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "585 N Mountain Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "CA",
            "postal_code": "917868516",
            "country_code": "US",
            "telephone_number": "909-608-7546",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "770 Magnolia Ave Ste 1H",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "CA",
            "postal_code": "928793121",
            "country_code": "US",
            "telephone_number": "951-734-8989",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1666 N Waterman Ave",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924045113",
            "country_code": "US",
            "telephone_number": "909-886-4965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINZER",
        "first_name": "IRYNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-17",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA55507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRYNA",
            "last_name": "KHLEBNIKAVA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelly Kimura, M.S., CCC-SLP
• Craig King, D.C.
• Nathan King, D.O.
• Barbara Jean Kinkle, PA-C
• Colleen Mary Kintner, LMFT
• Meaghan Leigh Kinzle, LMFT
• Aneeta Ramakrishna Kiran, MD
• Kirk G. Howard MD Inc
• Gwenyth Lavillia Kirkland
• Lindsay Ann Kirkland, MS, CCC-SLP

• Physician Assistant in Redlands, CA
• Providers in Redlands, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.