Individual provider Active NPI

John R Weinstein

  • Psychiatry Physician
  • Garden Grove, CA
National Provider Identifier
1255402608
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A64936 Issued in CA
Practice address
12373 Lewis St
Suite 103
Garden Grove, CA 92840-4676
Phone
(714) 867-6031
Fax
(714) 867-6033
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A64936 CA Primary

Addresses

Primary practice location

12373 Lewis St
Suite 103
Garden Grove, CA 92840-4676

Mailing address

409 N Pacific Coast Hwy
Suite 441
Redondo Beach, CA 90277-2870
Phone (714) 867-6031

Other identifiers 1

IdentifierTypeStateIssuer
00A649360MedicaidCA

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
I20050823001106 CA Practitioner - Psychiatry 3779514377 Practice locations: Garden Grove, CA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Medical College of Wisconsin, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12373 Lewis St
Suite 103
Garden Grove, CA 92840-4676
Phone (714) 867-6031

Merit-based Incentive Payment System (MIPS)

Final score
72.84 of 100Reported as individual
Quality
51.67
Promoting interoperability
28
Improvement activities
40
Cost
88.2

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64936CAMDPharmacist
A64936CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Psychfitness, Apmc Psychiatry Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1255402608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 N PACIFIC COAST HWY",
            "address_2": "SUITE 441",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902772870",
            "telephone_number": "714-867-6031",
            "fax_number": "714-867-6033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12373 LEWIS ST",
            "address_2": "SUITE 103",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404676",
            "telephone_number": "714-867-6031",
            "fax_number": "714-867-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINSTEIN",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A64936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A649360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.