Timothy D. Jenkins, MD
Individual provider Active NPI Gastroenterology Physician · Fontana, CA
NPI 1205903119 · NPPES record last updated Nov 29, 2021
Key facts
- NPI
- 1205903119
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gastroenterology Physician 207RG0100X
- License
- G85138 (CA)
- Practice address
- 9961 Sierra Ave
Fontana, CA 92335-6720 - Phone
- (909) 427-3910
- NPI assigned
- Nov 29, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Owned or controlled facilities with NPI records 2
Medicare Care Compare profile
- Specialty
- Gastroenterology
- Education
- Harvard Medical School, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southern California Permanente Medical Group
Practice addresses (Care Compare)
2295 S Vineyard Ave
Ontario, CA 91761-7925
Phone (909) 724-5000
9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-5000
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Kaiser Foundation Hospital - Fontana |
Hospital | Contracted Managing Employee (100%) | Jan 27, 2016 |
| Kaiser Foundation Hospital-Home Health Agency |
Home health agency | Contracted Managing Employee (100%) | Jan 27, 2016 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081118000576 | CA | Practitioner - Gastroenterology |
2961562178 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G85138 | CA | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910
393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | G85138 | CA | Yes |
Addresses
Primary practice location
9961 Sierra Ave
Fontana, CA 92335-6720
Mailing address
9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-3910
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Other providers in Fontana, CA
- Marie T. Jelonek
- Denise Jen
- Cathy E Jenkins-Etter
- Carla Jenkins-Skelton
- Hertha Jenkins
- Stephanie Jensen
- Sophia S Jeon
- Jason Jia
- Clara Jimenez
- Evangelina Jimenez
All providers in Fontana, CA · Gastroenterology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.