Mary Grace Cabatas Justiniani, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA 17249 Issued in CA

Practice address

14044 Victory Blvd
Van Nuys, CA 91401-2226

Phone

(818) 376-0405

NPI assigned

Feb 20, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Comprehensive Community Health Centers IncGroup PAC ID 9638082456, 47 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Comprehensive Community Health Centers Inc

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1356362743
  Medicare reassignment Care Compare group
• FHMC Group Inc

  • Primary Care Clinic/Center
  • Arleta, CA
  • NPI 1790306074
  NPD
• Domingo C Barrientos,MD

  • Family Medicine Physician
  • Van Nuys, CA
  • NPI 1255475356
  NPD (past)

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619012689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19120 JOVAN ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913356710",
            "telephone_number": "818-758-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14044 VICTORY BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914012226",
            "telephone_number": "818-376-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTINIANI",
        "first_name": "MARY GRACE",
        "middle_name": "CABATAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 17249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norma Jenny Julio
• Jiho Jung, RN
• Juno Medical Group
• Ruzanna Jurian, M.A., LMFT
• Hanako Justice
• Roxanne Marie Justiz-Aquino
• K & T Diagnostic, Inc.
• K & T Portable X-Ray Solutions
• K&D Injury Clinics
• Vicken Kabakian, LMFT

• Physician Assistant in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Physician Assistant 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.