Individual provider Active NPI

Justin Philip Anderson, M.D.

  • Emergency Medicine Physician
  • Orange, CA
National Provider Identifier
1659534121
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A109334 Issued in CA
Practice address
1310 W Stewart Dr Ste 212
Orange, CA 92868-3837
Phone
(714) 543-8911
Fax
(714) 543-8914
NPI assigned
Jul 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A109334 CA Primary

Addresses

Primary practice location

1310 W Stewart Dr Ste 212
Orange, CA 92868-3837

Mailing address

1310 W Stewart Dr Ste 212
Orange, CA 92868-3837
Phone (714) 543-8911

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
I20110414000764 CA Practitioner - Emergency Medicine 5597949503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, San Diego School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Specialists of Orange CountyGroup PAC ID 0840185005, 43 clinicians

Practice addresses (Care Compare)

1100 W Stewart Dr
Orange, CA 92868-3849
Phone (714) 633-9111

Hospital & facility affiliations

  • Providence St. Joseph Hospital Hospital, Orange, CA, CCN 050069

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A109334CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Specialists of Orange County Emergency Medicine CurrentSince Apr 1, 2011 Accepting new patients
James E. Pierog, MD, Inc. Past Accepting new patients

Locations

1100 W Stewart Dr
Orange, CA 92868
Phone (714) 532-8620

1310 W Stewart Dr
Ste 212
Orange, CA 92868
Phone (714) 543-8911

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.

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": "1215216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1659534121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 W STEWART DR STE 212",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683837",
            "telephone_number": "714-543-8911",
            "fax_number": "714-543-8914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 W STEWART DR STE 212",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683837",
            "telephone_number": "714-543-8911",
            "fax_number": "714-543-8914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JUSTIN",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-05",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A109334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.