Individual provider Active NPI

John Gilbert McNutt, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Newport Beach, CA
National Provider Identifier
1881603967
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
A61636 Issued in CA
Practice address
361 Hospital Rd
Suite 124
Newport Beach, CA 92663-3522
Phone
(949) 583-9944
Fax
(949) 583-9955
NPI assigned
Aug 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X A61636 CA Primary
Anesthesiology Physician 207L00000X A61636 CA

Addresses

Primary practice location

361 Hospital Rd
Suite 124
Newport Beach, CA 92663-3522

Mailing address

210 N Tustin Ave
Santa Ana, CA 92705-3807
Phone (714) 347-1010

Other identifiers 1

IdentifierTypeStateIssuer
00A616360MedicaidCA

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
I20051012000722 CA Practitioner - Anesthesiology 3173548831 Reassigns benefits to 1 organization
Practice locations: Newport Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Indiana University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allied Anesthesia Medical Group IncGroup PAC ID 6103728407, 185 clinicians

Practice addresses (Care Compare)

1798 N Garey Ave
Pomona, CA 91767-2918
Phone (909) 865-9500

Hospital & facility affiliations

  • Providence St Mary Medical Center Hospital, Apple Valley, CA, CCN 050300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61636CAMDEndodontist
A61636CAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Anesthesia Medical Group Inc Anesthesiology CurrentSince Feb 8, 2023 Accepting new patients
Northern California Anesthesia Associates Anesthesiology Past Accepting new patients
Community Anesthesia Associates, PC Anesthesiology Past Accepting new patients

Locations

1124 S Main St
Ste 101
Corona, CA 92882
Phone (951) 737-6363

455 S Main St
Orange, CA 92868
Phone (714) 289-4511

255 E Bonita Ave
Pomona, CA 91767
Phone (866) 724-4127

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

999 San Bernardino Rd
Upland, CA 91786
Phone (909) 920-4841

Interoperability endpoints

  • Direct secure messaging: jmcnutt473692@direct.llu.edu

Organizations & group practices 3

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 3

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": "1154822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1881603967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "714-347-1010",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 HOSPITAL RD",
            "address_2": "SUITE 124",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633522",
            "telephone_number": "949-583-9944",
            "fax_number": "949-583-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNUTT",
        "first_name": "JOHN",
        "middle_name": "GILBERT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-06",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "A61636",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A61636",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A616360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.