Individual provider Active NPI

Juan Sebastian Arana, DO

  • Pediatrics Physician
  • Brunswick, GA
National Provider Identifier
1952863649
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5101026297 Issued in MI
Practice address
3300 4TH St
Brunswick, GA 31520-3779
Phone
(912) 466-5870
NPI assigned
Apr 2, 2019
Last updated
Oct 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5101026297 MI Primary

Addresses

Primary practice location

3300 4TH St
Brunswick, GA 31520-3779

Mailing address

3031 W Grand Blvd Ste 450
Detroit, MI 48202-3026
Phone (772) 801-1509

Other practice location 1

3031 W Grand Blvd Ste 450
Detroit, MI 48202-3026
Phone (313) 871-3751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20231017002387 GA Practitioner - Pediatric Medicine 8325493984 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101026297MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Community Health Services, Inc. CurrentSince Jun 3, 2024 Accepting new patients
Cooperative Healthcare Services Inc Pediatrics CurrentSince Sep 11, 2023 Accepting new patients
Coastal Community Health Services Inc CurrentSince Jun 3, 2024 Accepting new patients
Partners in Wellness Past Accepting new patients
Southeast Georgia Health System, Inc. Past Accepting new patients
Detroit Wayne County Health Authority PastSince Jul 6, 2020 Accepting new patients

Locations

100 Professional Center Dr
Brunswick, GA 31525

106 Shoppers Way
Ste 101
Brunswick, GA 31525
Phone (912) 275-8208

2415 Parkwood Dr
Brunswick, GA 31520
Phone (912) 466-4079

3300 4th St
Brunswick, GA 31520
Phone (912) 267-0884

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19827/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1952863649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 W GRAND BLVD STE 450",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023026",
            "telephone_number": "772-801-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 4TH ST",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315203779",
            "telephone_number": "912-466-5870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3031 W Grand Blvd Ste 450",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482023026",
            "country_code": "US",
            "telephone_number": "313-871-3751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARANA",
        "first_name": "JUAN",
        "middle_name": "SEBASTIAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101026297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

Verify at the official NPI Registry.