Justin Elliott Katz

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

LL40871 Issued in SC

Practice address

4070 Highway 17
Murrells Inlet, SC 29576-5033

Phone

(843) 652-1293

NPI assigned

May 11, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VT

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

Specialty

HospitalistAlso: Family Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeastern Vermont Regional Hospital IncGroup PAC ID 3678481405, shared by 15 NPIs, 104 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeastern Vermont Regional Hospital Hospital, Saint Johnsbury, VT, CCN 471303
• Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Central Vermont Medical Center Inc

  • Family Medicine Physician
  • Berlin, VT
  • NPI 1023028784

  Family Medicine, VT

  Medicare reassignment NPD
• Central Vermont Medical Center Inc

  • Internal Medicine Physician
  • Berlin, VT
  • NPI 1831374362

  Family Medicine, VT

  Medicare reassignment NPD
• Northeastern Vermont Regional Hospital, Inc

  • Critical Access Hospital
  • St Johnsbury, VT
  • NPI 1174566541

  VT

  Medicare reassignment NPD
• Northeastern Vermont Regional Hospital, Inc

  • Critical Access Hospital
  • St Johnsbury, VT
  • NPI 1275576704

  VT

  Medicare reassignment NPD
• Northeastern Vermont Regional Hospital Inc

  • Specialist
  • St Johnsbury, VT
  • NPI 1760773774
  NPD
• Northeastern Vermont Regional Hospital Inc.

  • Podiatrist
  • St Johnsbury, VT
  • NPI 1710631635
  NPD
• Northeastern Vermont Regional Hospital, Inc

  • Critical Access Hospital
  • St Johnsbury, VT
  • NPI 1013430511
  NPD
• Northeastern Vermont Regional Hospital, Inc

  • Critical Access Hospital
  • St Johnsbury, VT
  • NPI 1326081811
  NPD
• Northeastern Vermont Regional Hospital, Inc

  • Critical Access Hospital
  • St Johnsbury, VT
  • NPI 1548202690
  NPD

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

• Mary Hitchcock Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1023092053

  Hospital

  Care Compare affiliation
• Mary Hitchcock Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1629788237

  Hospital

  Care Compare affiliation
• Northeastern Vermont Regional Hospital Inc.

  • Primary Care Clinic/Center
  • Lyndonville, VT
  • NPI 1659459428

  Hospital

  Care Compare affiliation
• Northeastern Vermont Regional Hospital Inc.

  • Podiatrist
  • St Johnsbury, VT
  • NPI 1710631635

  Hospital

  Care Compare affiliation
• Northeastern Vermont Regional Hospital, Inc

  • Critical Access Hospital
  • St Johnsbury, VT
  • NPI 1275576704

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1982131728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4070 HIGHWAY 17",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295765033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4070 HIGHWAY 17",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295765033",
            "telephone_number": "843-652-1293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Fisher Rd Unit 1",
            "address_purpose": "LOCATION",
            "city": "Berlin",
            "state": "VT",
            "postal_code": "056028132",
            "country_code": "US",
            "telephone_number": "802-225-1743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KATZ",
        "first_name": "JUSTIN",
        "middle_name": "ELLIOTT",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "042-0014893",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VT",
            "license": "042-0014893",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL40871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTH CAROLINA BOARD OF MEDICAL EXAMINERS",
            "identifier": "LL40871",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Dobson Jordan, MSP, CCC-SLP
• Joye Counseling Services, LLC
• Stacy Joye, LISW-CP
• Christine Elena Julien
• Jamie Kandora, MS, RD, LD
• Jason Michael Kaylor, PA-C
• Katie Newton Kennedy, DO
• Mariaantonette King, PHARM.D.
• Siera Makenzie Kirby, PA-C
• KJ Therapy Services, LLC

• All providers in Murrells Inlet, SC
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; 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.

Verify at the official NPI Registry.