Active NPI
Frederick Vinton, P.A.-C.
- Physician Assistant
- San Bernardino, CA
National Provider Identifier
1902162043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA22191
- Practice address
- 565 N Mount Vernon Ave
San Bernardino, CA 92411-2661 - Phone
- (909) 884-9091
- Fax
- (909) 383-7013
- NPI assigned
- Apr 3, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA22191 | CA | Primary |
Addresses
Primary practice location
565 N Mount Vernon Ave
San Bernardino, CA 92411-2661
Mailing address
685 Carnegie Dr
Suite 230
San Bernardino, CA 92408-3502
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA22191 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333411200000",
"number": "1902162043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "685 CARNEGIE DR",
"address_2": "SUITE 230",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924083502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "565 N MOUNT VERNON AVE",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924112661",
"telephone_number": "909-884-9091",
"fax_number": "909-383-7013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINTON",
"first_name": "FREDERICK",
"credential": "P.A.-C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-03",
"last_updated": "2012-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA22191",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.