Active NPI
Ryan Aaron Johnson, AU.D.
- Audiologist
- Bonita, CA
National Provider Identifier
1306281027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- Practice address
- 4190 Bonita Rd Ste 104
Bonita, CA 91902-1330 - Phone
- (619) 961-9130
- NPI assigned
- May 8, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | Primary |
Addresses
Primary practice location
4190 Bonita Rd Ste 104
Bonita, CA 91902-1330
Mailing address
1617 Brookes Ave Apt 7
San Diego, CA 92103-5138
Phone (858) 610-7808
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140820000509 | CA | Practitioner - Qualified Audiologist | 3173741998 | Practice locations: Bonita, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4190 Bonita Rd
Suite 104
Bonita, CA 91902-1330
Phone (619) 961-9130
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ryan Johnson | Audiologist | Past | Accepting new patients |
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.
-
- Audiologist
- Bonita, CA
- NPI 1912313842
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404777600000",
"number": "1306281027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1617 BROOKES AVE APT 7",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921035138",
"telephone_number": "858-610-7808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4190 BONITA RD STE 104",
"city": "BONITA",
"state": "CA",
"postal_code": "919021330",
"telephone_number": "619-961-9130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "RYAN",
"middle_name": "AARON",
"name_prefix": "Dr.",
"credential": "AU.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-08",
"last_updated": "2014-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bonita, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2014; 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.