Samantha Michelle Johnson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

33472 Issued in CA

Practice address

4545 E 3Rd St
Los Angeles, CA 90022-1656

Phone

(323) 261-3098

NPI assigned

Aug 9, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern California College of Optometry, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Samantha Johnson O.D., PC

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1760101588
  Medicare reassignment NPD Authorized official
• John Manuel Hernandez, O.D.

  • Optometrist
  • Huntington Park, CA
  • NPI 1114954856
  Medicare reassignment
• Dr Hernandez Optometry Inc

  • Optometrist
  • Huntington Park, CA
  • NPI 1164604658
  NPD

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1144774928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8640 GULANA AVE UNIT J2016",
            "city": "PLAYA DEL REY",
            "state": "CA",
            "postal_code": "902937321",
            "telephone_number": "619-820-2756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 E 3RD ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221656",
            "telephone_number": "323-261-3098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6134 Pacific Blvd",
            "address_purpose": "LOCATION",
            "city": "Huntington Park",
            "state": "CA",
            "postal_code": "902552923",
            "country_code": "US",
            "telephone_number": "323-589-3381",
            "fax_number": "323-583-6439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SAMANTHA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-09",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosa Letiya Ann Johnson, ED.D., ASW, RBT
• Rose Marie Johnson, LCSW
• Roya T Johnson
• Russell Andrew Johnson, M.D.
• Ryan Johnson
• Sarah Ashley Johnson, AMFT
• Sean Johnson
• Sean Dennis Johnson, PT, DPT
• Sean Lanier Johnson, MD
• Senetha Johnson

• Optometrist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.