Active NPI
Justin Q. Sanjuan, DO
- Pediatrics Physician
- Washington, DC
National Provider Identifier
1124768197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- DO210012552
- Practice address
- 111 Michigan Ave NW
Washington, DC 20010-2916 - Phone
- (202) 476-5000
- NPI assigned
- Mar 29, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | OH | ||
| Pediatrics Physician | 208000000X | DO210012552 | DC | Primary |
Addresses
Primary practice location
111 Michigan Ave NW
Washington, DC 20010-2916
Mailing address
Cleveland Clinic 9500 Euclid Avenue/NA-23
Cleveland, OH 44195-0001
Phone (216) 444-2200
Other practice location 1
Cleveland Clinic 9500 Euclid Avenue/Na-23
Cleveland, OH 44195-0001
Phone (216) 444-2200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220517001794 | OH | Order and Referring Only - Pediatric Medicine | 9931586732 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO210012552 | DC | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751760000000",
"number": "1124768197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CLEVELAND CLINIC 9500 EUCLID AVENUE/NA-23",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441950001",
"telephone_number": "216-444-2200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 MICHIGAN AVE NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200102916",
"telephone_number": "202-476-5000"
}
],
"practiceLocations": [
{
"address_1": "Cleveland Clinic 9500 Euclid Avenue/Na-23",
"address_purpose": "LOCATION",
"city": "Cleveland",
"state": "OH",
"postal_code": "441950001",
"country_code": "US",
"telephone_number": "216-444-2200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SANJUAN",
"first_name": "JUSTIN",
"middle_name": "Q.",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-03-29",
"last_updated": "2025-07-06",
"certification_date": "2025-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "DC",
"license": "DO210012552",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.