Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Edmundo Samuel Justino, MD

Individual provider Gastroenterology Physician · NPI 1720156136

Dr. Edmundo Samuel Justino, MD is a Gastroenterology in Prescott, Arizona. Graduated from University of Texas Medical Branch at Galveston in 2004, 22 years ago. Practices with Yavapai Regional Medical Center Physician Care LLC, a 119-clinician group and accepts Medicare assignment. Licensed in Arizona and North Dakota.

Years since qualifying
22
Trained at
University of Texas Medical Branch at Galveston
Licensed in
AZ, ND
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

802 Ainsworth Dr Ste A
Prescott, AZ 86301-1623
Phone: (928) 771-5548
Fax: (928) 771-5549
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gastroenterology Physician (primary) Taxonomy 207RG0100X · Licence 60368 (AZ)
Gastroenterology Physician Taxonomy 207RG0100X · Licence 11931 (ND)

Record details

NPI number1720156136
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedDecember 1, 2006
Last updated in NPPESSeptember 29, 2025
Certification dateSeptember 29, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGASTROENTEROLOGY
Medical schoolUNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Graduated 2004 (22 years in practice)
Group practice Yavapai Regional Medical Center Physician Care Llc — 119 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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