Individual provider Active NPI

Justin Harshman, PA

  • Physician Assistant
  • Hawthorne, CA
National Provider Identifier
1811713357
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
66046 Issued in CA
Practice address
14650 Aviation Blvd Ste 100
Hawthorne, CA 90250-6667
Phone
(323) 268-6731
NPI assigned
Nov 30, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 66046 CA Primary

Addresses

Primary practice location

14650 Aviation Blvd Ste 100
Hawthorne, CA 90250-6667

Mailing address

16906 NE 101St PL
Redmond, WA 98052-3143
Phone (425) 894-7660

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
I20250421002595 CA Practitioner - Physician Assistant 4981129004 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66046CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Employee Medical Consultants PC Past Accepting new patients
Michael R. Gatto MD, Inc. PastSince Aug 1, 2007 Accepting new patients
Citrus Valley Medical Associates, Inc. PastSince Aug 2, 2021 Accepting new patients
Samir a Shah MD Professional Corporation Past Accepting new patients

Organizations & group practices 5

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": "1732924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1811713357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16906 NE 101ST PL",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523143",
            "telephone_number": "425-894-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14650 AVIATION BLVD STE 100",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902506667",
            "telephone_number": "323-268-6731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARSHMAN",
        "first_name": "JUSTIN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-30",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "66046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

Verify at the official NPI Registry.