Active NPI
Justin Michael Greenberg, D.O.
- Pediatric Critical Care Medicine Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- 20A14267
- Practice address
- 200 UCLA Medical PLZ Ste 265
Los Angeles, CA 90095-8344 - Phone
- (310) 825-0867
- Fax
- (310) 794-5066
- NPI assigned
- Nov 13, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 20A14267 | CA | |
| Pediatric Critical Care Medicine Physician | 2080P0203X | DO2907 | NV | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Critical Care Medicine Physician | 2080P0203X | 20A14267 | CA | Primary |
Addresses
Primary practice location
200 UCLA Medical PLZ Ste 265
Los Angeles, CA 90095-8344
Mailing address
5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Other practice location 1
University Medical Center of Southern Nevada
1800 W. Charleston Blvd.
Las Vegas, NV 89102
Phone (702) 383-2420
Other practice location 2
1600 W Avenue J
Lancaster, CA 93534-2814
Phone (661) 949-5000
Other practice location 3
2020 Zonal Ave
IRD Suite 112
Los Angeles, CA 90033
Phone (323) 226-5584
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A14267 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| UC Regents | Pediatrics | Current | Accepting new patients |
| UCLA Medical Group | Pediatrics | Past | Accepting new patients |
Locations
1600 W Avenue J
Lancaster, CA 93534
Phone (661) 726-6254
200 UCLA Medical Plz
Ste 265
Los Angeles, CA 90095
Phone (310) 206-2429
File 2939
Los Angeles, CA 90074
Phone (310) 794-6596
5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200
10833 Le Conte Ave
#12311
Los Angeles, CA 90095
Phone (310) 825-9124
1260 15th St
Ste 1024
Santa Monica, CA 90404
Phone (424) 259-8570
215 W Janss Rd
Thousand Oaks, CA 91360
Phone (805) 379-5435
Interoperability endpoints
- jgreenberg1122623@direct.uclahealth.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba UCLA Dept of Pediatric Grp Practice
- Pediatrics Physician
- Los Angeles, CA
- NPI 1982667663
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675123200000",
"number": "1710383187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD STE 400",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 UCLA MEDICAL PLZ STE 265",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900958344",
"telephone_number": "310-825-0867",
"fax_number": "310-794-5066"
}
],
"practiceLocations": [
{
"address_1": "University Medical Center of Southern Nevada",
"address_2": "1800 W. Charleston Blvd.",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "89102",
"country_code": "US",
"telephone_number": "702-383-2420",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1600 W Avenue J",
"address_purpose": "LOCATION",
"city": "Lancaster",
"state": "CA",
"postal_code": "935342814",
"country_code": "US",
"telephone_number": "661-949-5000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2020 Zonal Ave",
"address_2": "IRD Suite 112",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "90033",
"country_code": "US",
"telephone_number": "323-226-5584",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GREENBERG",
"first_name": "JUSTIN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-11-13",
"last_updated": "2023-01-31",
"certification_date": "2023-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "20A14267",
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "NV",
"license": "DO2907",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "CA",
"license": "20A14267",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.