Individual provider Active NPI

Erik L Johnson, DO

  • Psychiatry Physician
  • San Bernardino, CA
National Provider Identifier
1245641935
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20A14580 Issued in CA
Practice address
303 E Vanderbilt Way
San Bernardino, CA 92415
Phone
(909) 458-1350
NPI assigned
May 15, 2014
Last updated
Jul 3, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 20A14580 CA Primary

Addresses

Primary practice location

303 E Vanderbilt Way
San Bernardino, CA 92415

Mailing address

400 N Pepper Ave
Colton, CA 92324-1801
Phone (415) 637-9465

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
I20180419000517 CA Practitioner - Psychiatry 7719240076 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of San BernardinoGroup PAC ID 3870499130, 76 clinicians
Cep America - Psychiatry PCGroup PAC ID 0244522159, 93 clinicians

Practice addresses (Care Compare)

1841 E Main St
Barstow, CA 92311-3234
Phone (760) 255-5700

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14580CAMDAddiction (Substance Use Disorder) Counselor
20A14580CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Psychiatry PC Psychiatry CurrentSince Sep 10, 2019 Accepting new patients
County of San Bernardino Current Accepting new patients
Cep America - Psychiatry PC Psychiatry CurrentSince Sep 10, 2019 Accepting new patients
Cep America - Psychiatry PC Psychiatry Current Accepting new patients
County of San Bernardino CurrentSince Aug 3, 2018 Accepting new patients

Locations

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1400

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2940 Inland Empire Blvd
Ontario, CA 91764
Phone (909) 458-1350

303 E Vanderbilt Way
Sn Bernrdno, CA 92415
Phone (909) 388-0801

Interoperability endpoints

  • Direct secure messaging: ejohnson142227@direct.llu.edu

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1400112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1245641935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "415-637-9465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E VANDERBILT WAY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92415",
            "telephone_number": "909-458-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ERIK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-15",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A14580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.