Individual provider Active NPI

Melanie Dyan Johansson, M.D.

  • Pain Medicine Physician
  • Citrus Heights, CA
National Provider Identifier
1134417447
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
C183026 Issued in CA
Practice address
6939 Sunrise Blvd Ste 106
Citrus Heights, CA 95610-3153
Phone
(916) 352-7777
Fax
(877) 354-4771
NPI assigned
Jul 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X C183026 CA Primary

Addresses

Primary practice location

6939 Sunrise Blvd Ste 106
Citrus Heights, CA 95610-3153

Mailing address

6939 Sunrise Blvd Ste 106
Citrus Heights, CA 95610-3153
Phone (916) 352-7777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20230328002434 CA Practitioner - Pain Management 1153581665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Virginia Commonwealth University, School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
California Pain Specialists IncGroup PAC ID 5395160907, 2 clinicians

Practice addresses (Care Compare)

6939 Sunrise Blvd
Suite 106
Citrus Heights, CA 95610-3153
Phone (916) 352-7777

Hospital & facility affiliations

  • Providence Queen of the Valley Medical Center Hospital, Napa, CA, CCN 050009

Merit-based Incentive Payment System (MIPS)

Final score
22 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
73.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C183026CAMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
California Pain Specialists Inc Pain Medicine CurrentSince May 1, 2025 Accepting new patients

Locations

6939 Sunrise Blvd
Ste 106
Citrus Heights, CA 95610
Phone (916) 352-7777

7777 Greenback Ln
Ste 102
Citrus Hts, CA 95610
Phone (916) 352-7777

935 Trancas St
Ste 2C
Napa, CA 94558
Phone (707) 259-0766

Organizations & group practices 1

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 2

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": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1134417447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6939 SUNRISE BLVD STE 106",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956103153",
            "telephone_number": "916-352-7777",
            "fax_number": "877-354-4771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6939 SUNRISE BLVD STE 106",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956103153",
            "telephone_number": "916-352-7777",
            "fax_number": "877-354-4771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSSON",
        "first_name": "MELANIE",
        "middle_name": "DYAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-20",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "C183026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Citrus Heights, CA

Sources for this page

Verify at the official NPI Registry.