Justin M. Elliott, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

C35252 Issued in CA

Practice address

7300 N Fresno St
Fresno, CA 93720-2941

Phone

(559) 448-4500

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Munro, Booth & Cutruzzola

  • Diagnostic Radiology Physician
  • Healdsburg, CA
  • NPI 1437103884
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437237344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST FL 7",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123429",
            "telephone_number": "510-625-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202941",
            "telephone_number": "559-448-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "JUSTIN",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "C35252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C352520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lani Lauri Ellingsworth
• Lindsay Danielle Ellington, BS
• Elliot Beach Corp
• Jason Allen Elliot, PA-C
• Elliott a. Schaffzin, M.D. Inc.
• Tyndall Gene Elliott, CATC I
• Bradley Charles Ellis, M.D.
• Courtney Ellis
• Deborah Lynne Ellis
• Fleurette Joy Ellis

• Diagnostic Radiology Physician in Fresno, CA
• Providers in Fresno, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.