ELAINE THERESE VAN GUNDY M.D., F.A.A.P.
NPI 1174565485
Specialist in Roseville, CA

Q: What is Elaine Van Gundy's NPI number?

The NPI number for Elaine Van Gundy is 1174565485. It was assigned to this individual provider in the NPPES registry on June 12, 2006.

Q: What is Elaine Van Gundy's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Q: When was this NPI record last updated?

The NPPES record for Elaine Van Gundy was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 12, 2006PECOS Enrolled

1451 SECRET RAVINE PKWY, SUITE 150, ROSEVILLE, CA 95661(916) 580-2420(916) 580-2402 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Elaine Therese Van Gundy M.d., F.a.a.p. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELAINE THERESE VAN GUNDY M.D., F.A.A.P. (NPI 1174565485) is an individual specialist in Roseville, California, licensed in California (C43153) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174565485

Entity TypeIndividualFemale

Primary Taxonomy174400000X

Provider Legal NameELAINE THERESE VAN GUNDYCredential: M.D., F.A.A.P.

Location Address1451 SECRET RAVINE PKWY, SUITE 150Roseville, CA 95661-4051

Mailing Address1451 Secret Ravine Pkwy, Suite 150Roseville, CA 95661-4051 · (916) 580-2420 · Fax (916) 580-2402

Phone(916) 580-2420

Fax(916) 580-2402

Sole ProprietorYes

Enumeration DateJune 12, 2006

Last NPPES UpdateJuly 9, 2007

✔ NPI 1174565485 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in CA · C43153

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

1451 SECRET RAVINE PKWY, Roseville, CA 95661

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Other Identifiers 2

Medicare UPINE29166CA

Medicaid00C431530CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elaine Therese Van Gundy M.d., F.a.a.p. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Elaine Van Gundy reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sutter Medical Foundation

13 mi

Diagnostic Radiology

2800 L ST FL 7
Sacramento, CA 95816

Reassigned Medicare billing, California enrollment
Medicare enrollment name: Sutter Valley Medical Foundation
3,056 clinicians in this Medicare group

NPI 1942524095 (916) 731-7857

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DONNA R. CHIPPS P.N.P.

Nurse Practitioner (Pediatrics)

1451 SECRET RAVINE PKWY, SUITE 150
ROSEVILLE, CA 95661

Placer County (916) 580-2412

MYRZA R PEREZ M.D.

Allergy & Immunology (Allergy)

1451 SECRET RAVINE PKWY, SUITE 150
ROSEVILLE, CA 95661

Placer County (916) 580-2412

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Elaine Van Gundy's NPI number?

The NPI number for Elaine Van Gundy is 1174565485. It was assigned to this individual provider in the NPPES registry on June 12, 2006.

Where is Elaine Van Gundy located?

Elaine Van Gundy practices at 1451 Secret Ravine Pkwy Suite 150, Roseville, CA 95661. The listed phone number is (916) 580-2420.

What is Elaine Van Gundy's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Elaine Van Gundy enrolled in Medicare?

Yes. Elaine Van Gundy is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Elaine Van Gundy's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Elaine Van Gundy reassigns Medicare benefits to Sutter Medical Foundation (Sacramento, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Elaine Van Gundy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Elaine Van Gundy was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.