Individual provider Active NPI

Gracie-Ann Dinkins, M.D.

  • Trauma Surgery Physician
  • Lynwood, CA
National Provider Identifier
1104838663
Registry record updated Apr 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
G77962 Issued in CA
Practice address
3737 Martin Luther King Jr Blvd
Suite 404
Lynwood, CA 90262-3513
Phone
(424) 213-4290
Fax
(424) 213-4295
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X G77962 CA Primary
Surgery Physician 208600000X G77962 CA

Addresses

Primary practice location

3737 Martin Luther King Jr Blvd
Suite 404
Lynwood, CA 90262-3513

Mailing address

3737 Martin Luther King Jr Blvd
Suite 404
Lynwood, CA 90262-3513
Phone (424) 213-4290

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040224000584 CA Practitioner - General Surgery 9739075193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of California, Irvine, California College of Medicine, 1991
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3630 E Imperial Hwy
Lynwood, CA 90262-2636
Phone (424) 213-4290

Hospital & facility affiliations

  • Martin Luther King, Jr. Community Hospital Hospital, Los Angeles, CA, CCN 050779

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G77962CAMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gracie-Ann Dinkins MD Inc Surgery CurrentSince Oct 21, 2004 Accepting new patients

Locations

3630 E Imperial Hwy
Lynwood, CA 90262
Phone (310) 900-7420

3737 Martin Luther King Jr Blvd
Ste 404
Lynwood, CA 90262
Phone (310) 537-2121

11200 Long Beach Blvd
Unit 594
Lynwood, CA 90262

Organizations & group practices 1

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 1

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1104838663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE 404",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623513",
            "telephone_number": "424-213-4290",
            "fax_number": "424-213-4295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE 404",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623513",
            "telephone_number": "424-213-4290",
            "fax_number": "424-213-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINKINS",
        "first_name": "GRACIE-ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "CA",
            "license": "G77962",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G77962",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

Verify at the official NPI Registry.