Elaine Vink, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA56119 Issued in CA

Practice address

420 Brookside Ave
Redlands, CA 92373-4610

Phone

(909) 793-2020

NPI assigned

Oct 9, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Autism Heroes

  • Behavior Analyst
  • Redlands, CA
  • NPI 1831722461
  NPD

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676678400000",
    "number": "1851866511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 LAKESIDE AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735759",
            "telephone_number": "520-235-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 BROOKSIDE AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734610",
            "telephone_number": "909-793-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINK",
        "first_name": "ELAINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2023-02-18",
        "certification_date": "2023-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "PA56119",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA56119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Feb 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.