Justin Puttha Tuot

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A174009 Issued in CA

Practice address

5957 W Ramsey St
Banning, CA 92220-3058

Phone

(951) 845-0313

NPI assigned

Apr 6, 2018

Last updated

Jul 29, 2021By the provider in NPPES

Sex

Male

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Loma Linda University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

DLR Family Medicine Medical Group, PCGroup PAC ID 0345683082, 10 clinicians

Community Alliance Medical Group IncGroup PAC ID 0446699896, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Gorgonio Memorial Hospital Hospital, Banning, CA, CCN 050054
• Redlands Community Hospital Hospital, Redlands, CA, CCN 050272

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BJCEDD

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.

• Community Alliance Medical Group Inc

  • Family Medicine Physician
  • Yucaipa, CA
  • NPI 1699545285
  Medicare reassignment Care Compare group NPD
• DLR Family Medicine Medical Group PC

  • Internal Medicine Physician
  • Yucaipa, CA
  • NPI 1295501708
  Medicare reassignment Care Compare group NPD
• Beaver Medical Group P C

  dba Optum

  • Family Medicine Physician
  • Redlands, CA
  • NPI 1649503319
  Medicare reassignment NPD
• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593

  Family Medicine

  Medicare reassignment NPD
• Beaver Medical Group P C

  • Physical Therapist
  • Redlands, CA
  • NPI 1427090281
  NPD
• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD
• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Addiction Medicine (Internal Medicine) Physician
  • Tustin, CA
  • NPI 1891981502
  NPD
• Cardiology Specialists Medical Group, Inc.

  • Specialist
  • Riverside, CA
  • NPI 1467487983
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Redlands Community Hospital

  • General Acute Care Hospital
  • Redlands, CA
  • NPI 1043354111
  Care Compare affiliation
• San Gorgonio Memorial Hospital

  • General Acute Care Hospital
  • Banning, CA
  • NPI 1568469997
  Care Compare affiliation

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1770080731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10069",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230069",
            "telephone_number": "909-335-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5957 W RAMSEY ST",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922203058",
            "telephone_number": "951-845-0313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2145 N Fairfield Rd",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454312580",
            "country_code": "US",
            "telephone_number": "937-702-4031",
            "fax_number": "937-702-4039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUOT",
        "first_name": "JUSTIN",
        "middle_name": "PUTTHA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-06",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A174009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Trujillo, LVN
• Arturo Trujillo Jr., LMFT
• Vanessa Trujillo, LCSW
• Trusmile Dental Hygiene Practice of Kim, Inc.
• Wei Che Tsai, MD
• Joel Wayne Umali, D.D.S.
• Unilab Corporation (DBA Quest Diagnostics Incorporated)
• Tukia Vakalahi
• Norma Valdez
• Georgina Valentine

• Family Medicine Physician in Banning, CA
• Providers in Banning, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.