Individual provider Active NPI

Ji-Guang Jin, MD

  • Anesthesiology Physician
  • Santa Ana, CA
National Provider Identifier
1053305359
Registry record updated Jun 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A74174 Issued in CA
Practice address
1001 N Tustin Ave
Santa Ana, CA 92705-3502
Phone
(714) 953-3500
NPI assigned
Sep 1, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A74174 CA Primary

Addresses

Primary practice location

1001 N Tustin Ave
Santa Ana, CA 92705-3502

Mailing address

PO Box 1809
Orange, CA 92856-0809
Phone (714) 560-1580

Other identifiers 1

IdentifierTypeStateIssuer
00A741740MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20071012000347 CA Practitioner - Anesthesiology 2163518796 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Landmark Anesthesia Medical GroupGroup PAC ID 5698055804, 19 clinicians
Anesthesia Associates of Southern California PCGroup PAC ID 5890273403, 13 clinicians

Practice addresses (Care Compare)

1001 N Tustin Ave
Santa Ana, CA 92705-3502
Phone (714) 953-3500

Hospital & facility affiliations

  • Orange County Global Medical Center Hospital, Santa Ana, CA, CCN 050746

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A74174CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Landmark Anesthesia Medical Group Anesthesiology CurrentSince Mar 1, 2024 Accepting new patients

Locations

2271 W Malvern Ave
Fullerton, CA 92833
Phone (562) 773-4243

555 E Hardy St
Inglewood, CA 90301
Phone (310) 419-8636

1001 N Tustin Ave
Santa Ana, CA 92705
Phone (714) 835-3555

Organizations & group practices 4

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": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435276800000",
    "number": "1053305359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1809",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928560809",
            "telephone_number": "714-560-1580",
            "fax_number": "714-560-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053502",
            "telephone_number": "714-953-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIN",
        "first_name": "JI-GUANG",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2015-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A74174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A741740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.