Active NPI
John Gilbert McNutt, M.D.
- Student in an Organized Health Care Education/Training Program
- Newport Beach, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- A61636
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A616360 | Medicaid | CA |
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
Enrollment records 1
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
Practice addresses (Care Compare)
1798 N Garey Ave
Pomona, CA 91767-2918
Phone (909) 865-9500
Hospital & facility affiliations
- Providence St Mary Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61636 | CA | MD | Endodontist |
| A61636 | CA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allied Anesthesia Medical Group Inc | Anesthesiology | Current | 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
- 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.
-
- Anesthesiology Physician
- Orange, CA
- NPI 1346267267
-
- Anesthesiology Physician
- Fremont, CA
- NPI 1740299080
-
- Anesthesiology Physician
- Indianapolis, IN
- NPI 1386695930
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Apple Valley, CA
- NPI 1669456299
-
- General Acute Care Hospital
- Apple Valley, CA
- NPI 1710109186
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.