Individual provider Active NPI

John Bernard Bornstein, M.D.

  • Anesthesiology Physician
  • Los Angeles, CA
National Provider Identifier
1427064369
Registry record updated Jul 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G38206 Issued in CA
Practice address
2476 Overland Ave
Suite 201
Los Angeles, CA 90064-3374
Phone
(310) 559-8276
Fax
(310) 559-8263
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G38206 CA Primary

Addresses

Primary practice location

2476 Overland Ave
Suite 201
Los Angeles, CA 90064-3374

Mailing address

2476 Overland Ave
Suite 201
Los Angeles, CA 90064-3374
Phone (310) 559-8276

Other identifiers 2

IdentifierTypeStateIssuer
00G382060MedicaidCA
00G382060OtherCABLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080204000337 CA Practitioner - Anesthesiology 3375625064 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G38206CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bayside Anesthesia Medical Group CurrentSince May 1, 2014 Accepting new patients
John B. Bornstein, M.D., Inc. Anesthesiology CurrentSince Dec 1, 1999 Accepting new patients

Locations

2476 Overland Ave
Ste 201
Los Angeles, CA 90064

225 S Lake Ave
Ste 535
Pasadena, CA 91101

1250 16th St
Santa Monica, CA 90404
Phone (310) 301-8695

1328 22nd St
Santa Monica, CA 90404
Phone (310) 829-5511

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436400000000",
    "number": "1427064369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2476 OVERLAND AVE",
            "address_2": "SUITE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900643374",
            "telephone_number": "310-559-8276",
            "fax_number": "310-559-8263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2476 OVERLAND AVE",
            "address_2": "SUITE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900643374",
            "telephone_number": "310-559-8276",
            "fax_number": "310-559-8263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORNSTEIN",
        "first_name": "JOHN",
        "middle_name": "BERNARD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2015-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G38206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G382060",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G382060",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.