Organization Active NPI

Oxnard Camarillo Anesthesiology Medical Group

  • Anesthesiology Physician
  • Camarillo, CA
National Provider Identifier
1548285307
Registry record updated May 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
OXNARD CAMARILLO ANESTHESIOLOGY MEDICAL GROUP
Practice address
2309 Antonio Ave
Camarillo, CA 93010-1414
Phone
(805) 988-2500
NPI assigned
Jul 13, 2006
Last updated
May 15, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2015

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

Authorized official

Name
Dr. Jon P. Belleville, M.D.NPI 1013069426
Title
General Partner
Phone
(310) 440-3131

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

2309 Antonio Ave
Camarillo, CA 93010-1414

Mailing address

3116 W March LN
Ste. 200
Stockton, CA 95219-2369
Phone (209) 473-6555

Other identifiers 2

IdentifierTypeStateIssuer
GR0081300MedicaidCA
CF8796OtherCARAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041008000798 CA Part B Supplier - Clinic/Group Practice 6507825031 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
Practice locations: Bakersfield, CA; Westlake Village, CA; Ventura, CA; Thousand Oaks, CA; Oxnard, CA; Camarillo, CA

National Provider Directory

National Provider Directory

Locations

2460 N Ponderosa Dr
Ste A117
Camarillo, CA 93010
Phone (805) 430-0002

2590 E Main St
Ventura, CA 93003
Phone (805) 477-6000

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431648000000",
    "number": "1548285307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3116 W MARCH LN",
            "address_2": "STE. 200",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952192369",
            "telephone_number": "209-473-6555",
            "fax_number": "209-473-6544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 ANTONIO AVE",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930101414",
            "telephone_number": "805-988-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OXNARD CAMARILLO ANESTHESIOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2015-05-15",
        "status": "A",
        "authorized_official_last_name": "BELLEVILLE",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "310-440-3131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0081300",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CF8796",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.