DR. EDMUNDO SAMUEL JUSTINO MD
NPI 1720156136
Internal Medicine - Gastroenterology in Prescott, AZ

Q: What is Edmundo Justino's NPI number?

The NPI number for Edmundo Justino is 1720156136. It was assigned to this individual provider in the NPPES registry on December 1, 2006.

Q: What is Edmundo Justino's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Edmundo Justino was last updated on September 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 01, 2006PECOS EnrolledAccepts Medicare Assignment

802 AINSWORTH DR STE A, PRESCOTT, AZ 86301(928) 771-5548(928) 771-5549 Get Directions Write a Review

NPPES record last updated: September 29, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 17, 2025, Sep 9, 2024, Mar 7, 2023 and 2 more (5 updates tracked since 2020).

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About Dr. Edmundo Samuel Justino Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. EDMUNDO SAMUEL JUSTINO MD (NPI 1720156136) is an individual gastroenterology provider in Prescott, Arizona, licensed in Arizona (60368) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Texas Medical Branch At Galveston (2004).

NPPES Registry Identity

NPI1720156136

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameDR. EDMUNDO SAMUEL JUSTINOCredential: MD

Location Address802 AINSWORTH DR STE APrescott, AZ 86301-1623

Mailing AddressPo Box 10880Prescott, AZ 86304-0880 · (602) 406-4786 · Fax (916) 636-4358

Phone(928) 771-5548

Fax(928) 771-5549

Sole ProprietorNo

Medical School CMSUniversity Of Texas Medical Branch At GalvestonGraduated 2004

Enumeration DateDecember 1, 2006

Last NPPES UpdateSeptember 29, 20255 updates tracked since enumeration

NPPES CertifiedSeptember 29, 2025

✔ NPI 1720156136 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

Licenses✔ Licensed in AZ · 60368✔ Licensed in ND · 11931

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

802 AINSWORTH DR STE A, Prescott, AZ 86301

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Other Identifiers 4

Medicaid215032801TX

OtherTXB107550TX · Medicare Ptan

Other60368AZ · Medical License

Medicaid007145AZ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Blue Cross Blue Shield of Arizona and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Edmundo Samuel Justino Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4284792516

PECOS Enrollment IDI20200619001190

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Edmundo Justino reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Yavapai Regional Medical Center Physician Care LLC

0.3 mi

Cardiovascular Disease

1001 WILLOW CREEK RD STE 2200
Prescott, AZ 86301

Reassigned Medicare billing, Arizona enrollment
138 clinicians in this Medicare group

NPI 1528394830 (928) 445-6025

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 17

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

308 services305 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

226 services222 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

198 services194 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

118 services118 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

117 services117 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

115 services115 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

94 services89 patients

Dilation of esophagus 43450

Dilation of the esophagus is a procedure aimed to stretch or open up your esophagus (the tube connecting your mouth to your stomach) when it's narrow. It helps to improve swallowing and alleviate discomfort. It's typically performed using a flexible tube or balloon, under sedation.

92 services92 patients

Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm 43249

This procedure involves using a flexible tube with a camera, called an endoscope, to gently expand narrowed areas in your esophagus, stomach, or upper small bowel. A small balloon is inflated, making it easier for food and liquid to pass through. It's safe and effective.

69 services60 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

69 services69 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

63 services60 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

50 services48 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

50 services50 patients

Injection beneath lining of large bowel using a flexible endoscope 45381

This procedure involves a flexible tube, called an endoscope, being inserted into the large bowel. A small needle is then passed through the tube to inject medication under the bowel lining. This is typically done to treat inflammation or bleeding.

28 services28 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

26 services26 patients

Control of bleeding of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43255

This procedure involves using a flexible tube with a light, called an endoscope, to examine and treat bleeding in the esophagus, stomach, or upper small bowel. It's a safe, effective way to control bleeding and ensure your digestive health.

16 services15 patients

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 86301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$127.71 typical visit price

range $55.44 – $168.60

Typical copayment $31.92 (range $13.86 – $42.15)

Most-billed visit code 99204

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEIDI LYNN ALTON NP

Nurse Practitioner (Adult Health)