NPIMap

Individual provider Active NPI

James William Tinkelenberg, PA-C

  • Physician Assistant
  • Mad River, CA
National Provider Identifier
1205978392
Registry record updated Dec 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
19044 Issued in CA
Practice address
321 Van Duzen Rd
Mad River, CA 95526-9508
Phone
(707) 574-6616
Fax
(707) 574-6523
NPI assigned
Feb 13, 2007
Last updated
Dec 12, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 19044 CA Primary

Addresses

Primary practice location

321 Van Duzen Rd
Mad River, CA 95526-9508

Mailing address

291 Cedar Gap Rd # a
Mad River, CA 95552-9531
Phone (707) 574-6111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110215000949 CA Practitioner - Physician Assistant 9830379379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of California, Davis School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Wecare Group, IncGroup PAC ID 7719929082, 2 clinicians

Practice addresses (Care Compare)

321 Van Duzen Rd
Mad River, CA 95526-9508
Phone 7075746616203

500 B St a
Scotia, CA 95565-0007
Phone (707) 764-5617

PO Box
Suite 7
Scotia, CA 95565-0007

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
19044CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Wecare Group, Inc. CurrentSince Nov 29, 2010 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
The Wecare Group, Inc. Past Accepting new patients

Locations

321 Van Duzen Rd
Mad River, CA 95526
Phone (707) 296-8060

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418342400000",
    "number": "1205978392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 CEDAR GAP RD # A",
            "city": "MAD RIVER",
            "state": "CA",
            "postal_code": "955529531",
            "telephone_number": "707-574-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 VAN DUZEN RD",
            "city": "MAD RIVER",
            "state": "CA",
            "postal_code": "955269508",
            "telephone_number": "707-574-6616",
            "fax_number": "707-574-6523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINKELENBERG",
        "first_name": "JAMES",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2014-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "19044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mad River, CA

Sources for this page

Verify at the official NPI Registry.