Individual provider Active NPI

Melissa Lynn Johnson, PT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1245998103
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4435 Eastgate Mall Ste 120
San Diego, CA 92121-1980
Phone
(858) 529-5898
NPI assigned
Dec 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CA Primary

Addresses

Primary practice location

4435 Eastgate Mall Ste 120
San Diego, CA 92121-1980

Mailing address

1550 S Juniper St Apt 18
Escondido, CA 92025-5843
Phone (619) 838-6108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220119002942 CA Practitioner - Physical Therapist in Private Practice 7416349667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eggleton and Langton Physical Therapy Management ServicesGroup PAC ID 0840192530, 64 clinicians

Practice addresses (Care Compare)

4435 Eastgate Mall
Suite 120
San Diego, CA 92121-1980
Phone (858) 587-8669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist CurrentSince Dec 20, 2021 Accepting new patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist CurrentSince Dec 20, 2021 Accepting new patients

Locations

2035 Corte del Nogal
Ste 200
Carlsbad, CA 92011
Phone (760) 931-8310

4435 Eastgate Mall
Ste 120
San Diego, CA 92121
Phone (858) 578-8669

10225 Austin Dr
Ste 204
Spring Valley, CA 91978
Phone (619) 670-4567

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1245998103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 S JUNIPER ST APT 18",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920255843",
            "telephone_number": "619-838-6108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4435 EASTGATE MALL STE 120",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211980",
            "telephone_number": "858-529-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MELISSA",
        "middle_name": "LYNN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-07",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.