Active NPI
Andrew Lester Juris, MD
- Pediatric Cardiology Physician
- Sacramento, CA
National Provider Identifier
1376537639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Cardiology Physician
- License
- A36417
- Practice address
- 5609 J St
Suite a
Sacramento, CA 95819-3957 - Phone
- (916) 452-5391
- Fax
- (916) 452-7471
- NPI assigned
- Sep 1, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Cardiology Physician | 2080P0202X | A36417 | CA | Primary |
Addresses
Primary practice location
5609 J St
Suite a
Sacramento, CA 95819-3957
Mailing address
5609 J St
Suite a
Sacramento, CA 95819-3957
Phone (916) 452-5391
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A364170 | Medicaid | CA |
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 |
|---|---|---|---|
| 36417 | CA | MD | Clinical Social Worker |
| A36417 | CA | MD | Pediatric Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Enloe Medical Center | Past | Accepting new patients | |
| Perinatal & Pediatric Specialists Medical Group Inc. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Chico, CA
- NPI 1720099328
-
- Specialist
- Sacramento, CA
- NPI 1114007432
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332115200000",
"number": "1376537639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5609 J ST",
"address_2": "SUITE A",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958193957",
"telephone_number": "916-452-5391",
"fax_number": "916-452-7471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5609 J ST",
"address_2": "SUITE A",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958193957",
"telephone_number": "916-452-5391",
"fax_number": "916-452-7471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JURIS",
"first_name": "ANDREW",
"middle_name": "LESTER",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-01",
"last_updated": "2012-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "CA",
"license": "A36417",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A364170",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.