Individual provider Active NPI

Justin Bradley Nast, MD

  • Aerospace Medicine Physician
  • Fairfield, CA
National Provider Identifier
1669465449
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Aerospace Medicine PhysicianTaxonomy code 2083A0100X
License
C172660 Issued in CA
Practice address
2470 Hilborn Rd Ste 100
Fairfield, CA 94534-1100
Phone
(707) 646-4600
NPI assigned
Aug 26, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X C172660 CA
Aerospace Medicine Physician 2083A0100X C172660 CA Primary
Gynecology Physician 207VG0400X C172660 CA

Addresses

Primary practice location

2470 Hilborn Rd Ste 100
Fairfield, CA 94534-1100

Mailing address

88 MDG/SGHJ
4881 Sugar Maple Dr
Wright-Patterson Afb, OH 45433
Phone (623) 330-5985

Other practice location 1

88 MDG/SGHJ
4881 Sugar Maple Dr
Wright-Patterson AFB, OH 45433
Phone (623) 330-5985

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210827002606 CA Practitioner - Other (Physician) 4688854839 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C172660CAMDAerospace Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northbay Healthcare Group CurrentSince Oct 1, 2021 Accepting new patients
Northbay Healthcare Group CurrentSince Oct 1, 2021 Accepting new patients
Northbay Healthcare Group Current Accepting new patients
Northbay Health Medical Foundation CurrentSince Jan 1, 2026 Accepting new patients

Locations

2470 Hilborn Rd
Ste 100
Fairfield, CA 94534
Phone (707) 646-4600

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

101 Bodin Cir
Travis AFB, CA 94535
Phone (707) 423-3000

101 Bodin Cir
#60
Travis AFB, CA 94535
Phone (707) 423-5174

1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000

1679 E Monte Vista Ave
Ste 104
Vacaville, CA 95688
Phone (707) 624-7400

1010 Nut Tree Rd
Ste 100B
Vacaville, CA 95687
Phone (707) 646-7999

101 Main St
Winters, CA 95694
Phone (530) 795-4123

Organizations & group practices 4

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": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1669465449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 MDG/SGHJ",
            "address_2": "4881 SUGAR MAPLE DR",
            "city": "WRIGHT-PATTERSON AFB",
            "state": "OH",
            "postal_code": "45433",
            "telephone_number": "623-330-5985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 HILBORN RD STE 100",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945341100",
            "telephone_number": "707-646-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "88 MDG/SGHJ",
            "address_2": "4881 Sugar Maple Dr",
            "address_purpose": "LOCATION",
            "city": "Wright-Patterson AFB",
            "state": "OH",
            "postal_code": "45433",
            "country_code": "US",
            "telephone_number": "623-330-5985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAST",
        "first_name": "JUSTIN",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "CA",
            "license": "C172660",
            "primary": false
        },
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "CA",
            "license": "C172660",
            "primary": true
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "C172660",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.