NPIMap

Individual provider Active NPI

Justin Co

  • Physician Assistant
  • Fremont, CA
National Provider Identifier
1326778093
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
63511 Issued in CA
Practice address
2000 Mowry Ave
Fremont, CA 94538-1716
Phone
(510) 818-7200
NPI assigned
Jun 14, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 63511 CA Primary

Addresses

Primary practice location

2000 Mowry Ave
Fremont, CA 94538-1716

Mailing address

2000 Mowry Ave
Fremont, CA 94538-1716
Phone (510) 818-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240524002663 CA Practitioner - Physician Assistant 3971945718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sah Orthopaedic AssociatesGroup PAC ID 1153692785, 8 clinicians

Practice addresses (Care Compare)

2000 Mowry Ave
Fremont, CA 94538-1716
Phone (510) 818-7200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
63511CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sah Orthopaedic Associates CurrentSince Apr 15, 2024 Accepting new patients
Sah Orthopaedic Associates CurrentSince Apr 15, 2024 Accepting new patients

Locations

2000 Mowry Ave
Fremont, CA 94538
Phone (510) 793-6653

695 Oak Grove Ave
Ste 200
Menlo Park, CA 94025
Phone (510) 818-7200

Organizations & group practices 2

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.

Hospital & facility affiliations 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1326778093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 MOWRY AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381716",
            "telephone_number": "510-818-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MOWRY AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381716",
            "telephone_number": "510-818-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CO",
        "first_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-14",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "63511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.