Individual provider Active NPI

Justin Lee Massengale, M.D.

  • Neurological Surgery Physician
  • Fresno, CA
National Provider Identifier
1003096736
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
238944 Issued in MA
Practice address
7300 N Fresno St
Fresno, CA 93720-2941
Phone
(559) 448-4000
NPI assigned
Nov 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 238944 MA Primary

Addresses

Primary practice location

7300 N Fresno St
Fresno, CA 93720-2941

Mailing address

7300 N Fresno St
Fresno, CA 93720-2941
Phone (559) 448-4000

Other identifiers 1

IdentifierTypeStateIssuer
110082708AMedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090910000316 MA Practitioner - Neurosurgery 2769537042 Reassigns benefits to 4 organizations
I20250314001140 CA Practitioner - Neurosurgery 2769537042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Stanford University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

7300 N Fresno St
Fresno, CA 93720-2941
Phone (559) 448-4500

Hospital & facility affiliations

  • Kaiser Foundation Hospital - Fresno Hospital, Fresno, CA, CCN 050710

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Steward Medical Group, Inc CurrentSince Mar 7, 2016 Accepting new patients
Permanente Medical Group Inc CurrentSince Mar 17, 2025 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Jul 1, 2020 Accepting new patients
Jordan Physician Associates, Inc. CurrentSince Sep 1, 2020 Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jul 1, 2020 Accepting new patients
Jordan Physician Associates, Inc. CurrentSince Sep 1, 2020 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jul 1, 2020 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Jul 1, 2020 Accepting new patients
Steward Medical Group, Inc CurrentSince Mar 7, 2016 Accepting new patients
Permanente Medical Group, Inc CurrentSince Mar 17, 2025 Accepting new patients

Locations (25 of 27)

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

7300 N Fresno St
Fresno, CA 93720
Phone (207) 448-4500

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

5820 Owens Dr
Bldg E
Pleasanton, CA 94588
Phone (925) 737-3785

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

145 Rosemary St
Ste B
Needham Heights, MA 02494
Phone (781) 433-2110

275 Sandwich St
Plymouth, MA 02360
Phone (508) 746-2000

10 Cordage Park Cir
Ste 227
Plymouth, MA 02360
Phone (508) 746-1259

10 Cordage Park Cir
Ste 225
Plymouth, MA 02360
Phone (508) 830-6991

46 Obery St
Plymouth, MA 02360
Phone (508) 210-5920

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

Organizations & group practices 12

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1003096736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202941",
            "telephone_number": "559-448-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202941",
            "telephone_number": "559-448-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSENGALE",
        "first_name": "JUSTIN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-09",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MA",
            "license": "238944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110082708A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7300 N Fresno St",
            "city": "Fresno",
            "state": "CA",
            "country_code": "US",
            "postal_code": "937202941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.