NPIMap

Individual provider Active NPI

Jeremiah Nicholas Johnson, M.D.

  • Neurological Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1124220231
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
A129261 Issued in CA
Practice address
300 Stein Plaza Suite 420
Los Angeles, CA 90095-3905
Phone
(310) 825-5111
NPI assigned
Jun 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X Q3898 TX
Neurological Surgery Physician 207T00000X A129261 CA Primary

Addresses

Primary practice location

300 Stein Plaza Suite 420
Los Angeles, CA 90095-3905

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

7200 Cambridge, 9th Floor
Houston, TX 78229-3905
Phone (713) 798-4696

Other practice location 2

1131 Wilshire Blvd Ste 100
Santa Monica, CA 90401-2072
Phone (310) 319-3475

Other identifiers 1

IdentifierTypeStateIssuer
346356401MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140709002446 CA Practitioner - Neurosurgery 4587889498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Medical College of Georgia School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Regents of the University of CaliforniaGroup PAC ID 1355249491, 43 clinicians

Practice addresses (Care Compare)

26585 Agoura Rd
Calabasas, CA 91302-1958

300 Medical PLZ
Los Angeles, CA 90095-0001
Phone (310) 825-5111

757 Westwood PLZ
Los Angeles, CA 90095-8358

Hospital & facility affiliations

  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262
  • Lac/Harbor-UCLA Med Center Hospital, Torrance, CA, CCN 050376
  • Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112
  • UCLA West Valley Medical Center Hospital, West Hills, CA, CCN 050481

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A129261CAMDNeurological Surgery Physician
Q3898TXMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California Neurological Surgery CurrentSince Jul 1, 2021 Accepting new patients
The Regents of the University of California Neurological Surgery CurrentSince Jul 1, 2021 Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients
CHI St. Luke'S Health Baylor College of Medicine Medical Center Past Accepting new patients
Bexar County Hospital District Past Accepting new patients
UCLA Medical Group Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
Memorial Multispecialty Associates Past Accepting new patients

Locations

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 54206
Los Angeles, CA 90074

757 Westwood Plz
Los Angeles, CA 90095
Phone (310) 267-9448

300 Stein Plz
Ste 420
Los Angeles, CA 90095
Phone (310) 267-2621

1131 Wilshire Blvd
Ste 100
Santa Monica, CA 90401
Phone (310) 458-2381

Interoperability endpoints

  • Direct secure messaging: jjohnson914359@direct.uclahealth.org

Organizations & group practices 9

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1124220231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 STEIN PLAZA SUITE 420",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953905",
            "telephone_number": "310-825-5111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7200 Cambridge, 9th Floor",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "782293905",
            "country_code": "US",
            "telephone_number": "713-798-4696",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1131 Wilshire Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904012072",
            "country_code": "US",
            "telephone_number": "310-319-3475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEREMIAH",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "Q3898",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A129261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "346356401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.