John Willis Puckett, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

G38172A Issued in CA

Practice address

520 Superior Ave
#370
Newport Beach, CA 92663-3637

Phone

(949) 574-7176

Fax

(949) 574-7180

NPI assigned

Sep 29, 2006

Last updated

Aug 24, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• John W Puckett MD Facs Inc

  • Vascular Surgery Physician
  • Newport Beach, CA
  • NPI 1841419454
  Authorized official Same address or phone

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1306938022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 SUPERIOR AVE",
            "address_2": "#370",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633637",
            "telephone_number": "949-574-7176",
            "fax_number": "949-574-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 SUPERIOR AVE",
            "address_2": "#370",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633637",
            "telephone_number": "949-574-7176",
            "fax_number": "949-574-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCKETT",
        "first_name": "JOHN",
        "middle_name": "WILLIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "G38172A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Janae Pruzensky
• Psychological Healing, Inc
• Psylexis, a Professional Psychological Corporation
• Jose Puangco, M.D.
• Sherisse Sofia Puatu, DNP, FNP-BC
• Susan Pugach, CNC
• Peggy Ann Pugh, M.D.
• Jenny Puglisi
• Nicole Pullen, ASW
• Pulmonary Group of Newport Beach Inc.

• Vascular Surgery Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Vascular Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.