C. Gregory Jellinek, M.D. Inc

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

G035646 Issued in CA

Practice address

11209 Brockway Road
Suite 201
Truckee, CA 96161

Phone

(530) 587-8600

Fax

(530) 587-8606

NPI assigned

Oct 18, 2006

Last updated

Jan 14, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Aesthetica Plastic Surgicenter

  • Ambulatory Surgical Clinic/Center
  • Los Gatos, CA
  • NPI 1588745921
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1861573305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11209 BROCKWAY ROAD",
            "address_2": "SUITE 201",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961612218",
            "telephone_number": "530-587-8600",
            "fax_number": "530-587-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11209 BROCKWAY ROAD",
            "address_2": "SUITE 201",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "96161",
            "telephone_number": "530-587-8600",
            "fax_number": "530-587-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JELLINEK, M.D. INC",
        "first_name": "C.",
        "middle_name": "GREGORY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "G035646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aysia Jackson
• Christine Farson Jackson, O.D.
• Megan Jamison, LCSW
• Andrew Jaye
• Jeffrey Dodd MD a Professional Corporation
• Daniel Jenkins
• Reini Jensen
• Michael Jernick, M.D.
• Nicole McCrory Constantz Jernick, MD
• Hilary Suzanne Jimenez

• Plastic Surgery Physician in Truckee, CA
• Providers in Truckee, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; 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.