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

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: August 09, 2026.

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, and ordering and referring status from the CMS PECOS system.

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.

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.

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.