Individual provider Active NPI

Justin James Nork, D.O.

  • Urology Physician
  • San Diego, CA
National Provider Identifier
1093897860
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
20A16623 Issued in CA
Practice address
Naval Medical Center San Diego 34800 Bob Wilson Drive
San Diego, CA 92134-0001
Phone
(619) 532-7200
Fax
(619) 532-7234
NPI assigned
Oct 20, 2006
Last updated
Jan 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0116018955 VA
Urology Physician 208800000X 20A16623 CA Primary
Urology Physician 208800000X DO-P-2025-002 GU

Addresses

Primary practice location

Naval Medical Center San Diego 34800 Bob Wilson Drive
San Diego, CA 92134-0001

Mailing address

Naval Medical Center San Diego 34800 Bob Wilson Drive
San Diego, CA 92134-0001
Phone (619) 532-7200

Other practice location 1

200 Medical Plaza Ste 140
Los Angeles, CA 90095
Phone (310) 794-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
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
I20260312001603 GU Practitioner - Urology 2264782341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

133 Route 3
Dededo, GU 96929-6911
Phone (671) 645-5500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0116018955VAMDSurgery Physician
20A16623CAMDUrology Physician
DO-P-2025-002GUMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guam Healthcare Development Incorporated CurrentSince Dec 24, 2025 Accepting new patients

Locations

133 Route 3
Dededo, GU 96929
Phone (671) 645-5500

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1093897860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL CENTER SAN DIEGO 34800 BOB WILSON DRIVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921340001",
            "telephone_number": "619-532-7200",
            "fax_number": "619-532-7234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL CENTER SAN DIEGO 34800 BOB WILSON DRIVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921340001",
            "telephone_number": "619-532-7200",
            "fax_number": "619-532-7234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Medical Plaza Ste 140",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90095",
            "country_code": "US",
            "telephone_number": "310-794-7700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NORK",
        "first_name": "JUSTIN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0116018955",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "20A16623",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GU",
            "license": "DO-P-2025-002",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.