Active NPI
John M Anastasatos, MD
- Plastic Surgery Physician
- Beverly Hills, CA
National Provider Identifier
1245285048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- A92907
- Practice address
- 436 N Bedford Dr Ste 215
Beverly Hills, CA 90210-4312 - Phone
- (310) 888-4048
- Fax
- (310) 888-2827
- NPI assigned
- May 23, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 271451 | NY | |
| Plastic Surgery Physician | 208200000X | 22756 | AL | |
| Plastic Surgery Physician | 208200000X | A92907 | CA | Primary |
Addresses
Primary practice location
436 N Bedford Dr Ste 215
Beverly Hills, CA 90210-4312
Mailing address
436 N Bedford Dr Ste 215
Beverly Hills, CA 90210-4312
Phone (310) 888-4048
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051509016 | Other | AL | BLUE CROSS |
| 051509016 | Medicaid | AL | |
| 051509018 | Other | AL | BLUE CROSS |
| 051519920 | Other | AL | BLUE CROSS |
| 051529761 | Other | AL | BLUE CROSS |
| 009932161 | Medicaid | AL | |
| 009943075 | Medicaid | AL | |
| 240007710 | Other | AL | RAILROAD MEDICARE |
| 009994720 | Medicaid | AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22756 | AL | MD | Plastic Surgery Physician |
| A92907 | CA | MD | Plastic Surgery Physician |
| 271451 | NY | MD | Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573603200000",
"number": "1245285048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "436 N BEDFORD DR STE 215",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902104312",
"telephone_number": "310-888-4048",
"fax_number": "310-888-2827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "436 N BEDFORD DR STE 215",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902104312",
"telephone_number": "310-888-4048",
"fax_number": "310-888-2827"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANASTASATOS",
"first_name": "JOHN",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-23",
"last_updated": "2019-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "NY",
"license": "271451",
"primary": false
},
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "AL",
"license": "22756",
"primary": false
},
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "CA",
"license": "A92907",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "051509016",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "051509016",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "051509018",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "051519920",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "051529761",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009932161",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009943075",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "240007710",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009994720",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beverly Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.