Individual provider Active NPI

Andrew Jordan Kantzos, MD

  • Orthopaedic Surgery Physician
  • Loma Linda, CA
National Provider Identifier
1366936890
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
A197949 Issued in CA
Practice address
11234 Anderson St
Loma Linda, CA 92350-1716
Phone
(909) 558-4000
NPI assigned
Jun 18, 2018
Last updated
Jan 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A197949 CA Primary

Addresses

Primary practice location

11234 Anderson St
Loma Linda, CA 92350-1716

Mailing address

27000 W Lugonia Ave Apt 12316
Redlands, CA 92374-2099
Phone (480) 234-0773

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
I20241106003277 CA Practitioner - Orthopedic Surgery 7911431440 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Arizona College of Medicine - Phoenix, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

11370 Anderson St
Loma Linda, CA 92354-3450

25455 Barton Rd
Loma Linda, CA 92354-3128
Phone (909) 558-2808

900 E Washington St
Suite 200
Colton, CA 92324-4192
Phone (909) 558-4000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A197949CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sac Health System Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Sac Health System CurrentSince Dec 17, 2024 Accepting new patients
Sac Health System CurrentSince Dec 17, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Aug 31, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Orthopaedic Surgery CurrentSince Aug 31, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Orthopaedic Surgery Past Accepting new patients

Locations

900 E Washington St
Ste 200
Colton, CA 92324
Phone (909) 882-5867

82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11406 Loma Linda Dr
Ste 300
Loma Linda, CA 92354
Phone (909) 558-6277

25455 Barton Rd
Loma Linda, CA 92354
Phone (909) 558-2808

25455 Barton Rd
Ste 102B
Loma Linda, CA 92354
Phone (909) 558-2808

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

250 S G St
San Bernardino, CA 92410
Phone (909) 771-2990

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

Interoperability endpoints

  • Direct secure messaging: akantzos1228889@direct.llu.edu

Organizations & group practices 7

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1366936890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27000 W LUGONIA AVE APT 12316",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742099",
            "telephone_number": "480-234-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501716",
            "telephone_number": "909-558-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANTZOS",
        "first_name": "ANDREW",
        "middle_name": "JORDAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-18",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A197949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.