Individual provider Active NPI

Christopher Scott Justino, P.A.

  • Surgical Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1720370117
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA21363 Issued in CA
Practice address
1520 San Pablo Street
Suite 4300
Los Angeles, CA 90033-5324
Phone
(323) 442-5849
NPI assigned
May 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA21363 CA Primary

Addresses

Primary practice location

1520 San Pablo Street
Suite 4300
Los Angeles, CA 90033-5324

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-5849

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address christopher.justino@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111018000843 CA Practitioner - Physician Assistant 7214109156 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
21363CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Sep 6, 2011 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Sep 6, 2011 Accepting new patients

Locations

1520 San Pablo St
Ste 4300
Los Angeles, CA 90033
Phone (323) 442-5849

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

Interoperability endpoints

  • Direct secure messaging: christopher.justino@direct.usc.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1720370117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-5849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO STREET",
            "address_2": "SUITE 4300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335324",
            "telephone_number": "323-442-5849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTINO",
        "first_name": "CHRISTOPHER",
        "middle_name": "SCOTT",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-04",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA21363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "christopher.justino@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1520 San Pablo Street",
            "address_2": "Suite 4300",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.