Individual provider Active NPI

Brock Justin Lanier, MD

  • Plastic Surgery Physician
  • Newport Beach, CA
National Provider Identifier
1871702852
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A130654 Issued in CA
Practice address
2661 Vista Ornada
Newport Beach, CA 92660-3555
Phone
(202) 664-3553
NPI assigned
May 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X A130654 CA Primary

Addresses

Primary practice location

2661 Vista Ornada
Newport Beach, CA 92660-3555

Mailing address

2661 Vista Ornada
Newport Beach, CA 92660-3555
Phone (202) 664-3553

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170719003102 CA Practitioner - General Surgery 9133414279 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Tennessee, HSC, College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

601 Dover Dr
Suite 2
Newport Beach, CA 92663-5700
Phone (949) 229-7971

Hospital & facility affiliations

  • Los Angeles General Medical Center Hospital, Los Angeles, CA, CCN 050373

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A130654CAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Plastic Surgery CurrentSince Sep 17, 2018 Accepting new patients
Socal Oncoplastic Surgery PC Plastic Surgery CurrentSince Dec 1, 2024 Accepting new patients
Lucile Salter Packard Children'S Hospital at Stanford Past Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients

Locations

1640 Newport Blvd
Ste 240
Costa Mesa, CA 92627
Phone (949) 999-2411

601 Dover Dr
Ste 2
Newport Beach, CA 92663
Phone (949) 229-7971

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

200 S Manchester Ave
Ste 300
Orange, CA 92868
Phone (714) 424-9001

200 S Manchester Ave
Ste 650
Orange, CA 92868
Phone (714) 456-3077

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1871702852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2661 VISTA ORNADA",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926603555",
            "telephone_number": "202-664-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2661 VISTA ORNADA",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926603555",
            "telephone_number": "202-664-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANIER",
        "first_name": "BROCK",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A130654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.