John Hearst Welborn Jr., M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

A61831 Issued in CA

Practice address

1700 San Pablo Ave
Suite a
Pinole, CA 94564-2081

Phone

(510) 724-4600

Fax

(510) 964-0607

NPI assigned

Jun 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. J. Hearst Welborn Jr. Other name

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

Specialty

Orthopedic SurgeryAlso: Hand Surgery

Education

Medical College of Georgia School of Medicine, 1995

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Alta Bates Summit Medical Center - Alta Bates Camp Hospital, Berkeley, CA, CCN 050305

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwelborn240154@hisp.ehr.sutterhealth.org

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.

• John H Welborn MD Professional Corporation

  • Orthopaedic Surgery Physician
  • Pinole, CA
  • NPI 1972458669
  NPD Authorized official
• Marin General Hospital

  • General Acute Care Hospital
  • Greenbrae, CA
  • NPI 1396725677
  NPD (past)

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

• Sutter Bay Hospitals

  dba Alta Bates Summit Medical Center - Alta Bates Campus

  • General Acute Care Hospital
  • Berkeley, CA
  • NPI 1639523004
  Care Compare affiliation

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1235179144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SAN PABLO AVE",
            "address_2": "SUITE A",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642081",
            "telephone_number": "510-724-4600",
            "fax_number": "510-964-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SAN PABLO AVE",
            "address_2": "SUITE A",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642081",
            "telephone_number": "510-724-4600",
            "fax_number": "510-964-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELBORN",
        "first_name": "JOHN",
        "middle_name": "HEARST",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A61831",
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "CA",
            "license": "A61831",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A618310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "J.",
            "last_name": "WELBORN",
            "middle_name": "HEARST",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dale Watson, PHD
• Gordon Lee Watson Jr., D.D.S. INC
• Theresa Fitzgerald Weber, PT
• Webster Surgery Center, LP
• Elizabeth Weintraub, MSOT, OTR/L
• West County Orthopaedic Clinic
• Ladonna Rene' White, MSW, ASW
• Lena Krystyna-Tishkovskay Wiley
• Barbara Ellen Wilkins, MFT
• William C Lyon MD, a Professional Corporation

• Orthopaedic Surgery Physician in Pinole, CA
• Providers in Pinole, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.