Individual provider Active NPI

Kimberly Ellen Minesinger, D.O

  • Family Medicine Physician
  • Corona, CA
National Provider Identifier
1346344702
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A7484 Issued in CA
Practice address
1820 Fullerton Ave Ste 115
Corona, CA 92881-3160
Phone
(951) 817-5000
Fax
(951) 817-5002
NPI assigned
Sep 7, 2006
Last updated
Apr 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A7484 CA Primary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 20A7484 CA

Addresses

Primary practice location

1820 Fullerton Ave Ste 115
Corona, CA 92881-3160

Mailing address

1901 Town and Country Dr
Ste. 104
Norco, CA 92860-3611

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
I20040304001202 CA Practitioner - Family Practice 8426946286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Citrus Valley Medical Associates IncGroup PAC ID 0446329932, 14 clinicians

Practice addresses (Care Compare)

2250 S Main St
Suite 104
Corona, CA 92882-2538
Phone (951) 737-1454

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Citrus Valley Medical Associates, Inc. Family Medicine CurrentSince May 8, 2008 Accepting new patients
Geoffrey Trenkle DO a Professional Medical Corporation CurrentSince Jul 25, 2026 Accepting new patients
Uhs Corona Inc PastSince May 8, 2008 Accepting new patients
Aliuddin Khaja, MD., Inc Past Accepting new patients

Locations

1820 Fullerton Ave
Ste 115
Corona, CA 92881
Phone (951) 817-5000

2250 S Main St
Ste 104
Corona, CA 92882
Phone (951) 734-3233

2250 S Main St
Ste 208
Corona, CA 92882
Phone (951) 317-7657

1901 Town and Country Dr
Ste 104
Norco, CA 92860
Phone (951) 737-8141

940 N Haven Ave
Ste 18025
Ontario, CA 91764

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kimberly.minesinger.p1@direct.cvma.nextgenshare.com

Organizations & group practices 4

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 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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1346344702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 TOWN AND COUNTRY DR",
            "address_2": "STE. 104",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928603611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 FULLERTON AVE STE 115",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928813160",
            "telephone_number": "951-817-5000",
            "fax_number": "951-817-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINESINGER",
        "first_name": "KIMBERLY",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A7484",
            "primary": true
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "20A7484",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.