Individual provider Active NPI

Greta Jo

  • Anesthesiology Physician
  • Mission Viejo, CA
National Provider Identifier
1417122086
Registry record updated May 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A147242 Issued in CA
Practice address
26522 La Alameda Ste 370
Mission Viejo, CA 92691
Phone
(949) 600-7864
NPI assigned
Apr 24, 2008
Last updated
May 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X P2690 TX
Anesthesiology Physician 207L00000X A147242 CA Primary

Addresses

Primary practice location

26522 La Alameda Ste 370
Mission Viejo, CA 92691

Mailing address

26522 La Alameda Ste 370
Mission Viejo, CA 92691-6330

Other practice location 1

921 Gessner Rd Ste 226
Houston, TX 77024-2501
Phone (713) 242-3439

Other practice location 2

26522 La Alameda Ste 370
Mission Viejo, CA 92691
Phone (949) 600-7864

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
I20170920003663 CA Practitioner - Anesthesiology 3577705524 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Texas Medical Branch at Galveston, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Anesthesia Medical Associates IncGroup PAC ID 7012902216, 49 clinicians

Practice addresses (Care Compare)

27700 Medical Ctr Rd
Mission Viejo, CA 92691-6426
Phone (949) 364-1400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A147242CAMDAnesthesiology Physician
P2690TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Anesthesia Medical Associates Inc Anesthesiology CurrentSince Jul 1, 2018 Accepting new patients
Premiercare Anesthesia Fountain Valley Inc Anesthesiology CurrentSince Oct 1, 2017 Accepting new patients

Locations

10900 Warner Ave
Ste 101A
Fountain Valley, CA 92708
Phone (714) 698-1270

17100 Euclid St
Fountain Vly, CA 92708
Phone (714) 966-7200

23025 Mill Creek Dr
Ste 203
Laguna Hills, CA 92653

27882 Forbes Rd
Ste 203
Laguna Niguel, CA 92677
Phone (949) 347-2400

26522 La Alameda
Ste 370
Mission Viejo, CA 92691
Phone (949) 600-7864

27700 Medical Center Rd
Mission Viejo, CA 92691
Phone (949) 364-7744

653 Camino de los Mares
Ste 101
San Clemente, CA 92673
Phone (949) 489-2221

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 2

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": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558828800000",
    "number": "1417122086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26522 LA ALAMEDA STE 370",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26522 LA ALAMEDA STE 370",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92691",
            "telephone_number": "949-600-7864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "921 Gessner Rd Ste 226",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770242501",
            "country_code": "US",
            "telephone_number": "713-242-3439",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "26522 La Alameda Ste 370",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "92691",
            "country_code": "US",
            "telephone_number": "949-600-7864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JO",
        "first_name": "GRETA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2019-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "P2690",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A147242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.