Active NPI
Cary Alexander Johnson, M.D.
- Anatomic Pathology Physician
- Orange, CA
National Provider Identifier
1407023922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology Physician
- License
- C158492
- Practice address
- 101 The City Dr S
Orange, CA 92868-3201 - Phone
- (714) 880-7812
- NPI assigned
- May 14, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology Physician | 207ZP0101X | C158492 | CA | Primary |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 226610 | NY |
Addresses
Primary practice location
101 The City Dr S
Orange, CA 92868-3201
Mailing address
200 S Manchester Ave Ste 300
Orange, CA 92868-3219
Phone (714) 456-2986
Other practice location 1
10 Nathan D Perlman Pl
Suite 12S34
New York, NY 10003-3851
Phone (212) 420-2124
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C158492 | CA | MD | Anatomic Pathology Physician |
| 226610 | NY | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the University of California | Anatomic Pathology & Clinical Pathology | Current | Accepting new patients |
| Regents of the University of California | Anatomic Pathology & Clinical Pathology | Current | Accepting new patients |
| University of California Irvine | Past | Accepting new patients | |
| Scripps Health | Past | Accepting new patients |
Locations
101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054
Organizations & group practices 4
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.
-
- Anatomic Pathology & Clinical Pathology Physician
- Orange, CA
- NPI 1174662555
-
- Anatomic Pathology & Clinical Pathology Physician
- Orange, CA
- NPI 1558311811
-
- General Acute Care Hospital
- La Jolla, CA
- NPI 1841277704
-
- General Acute Care Hospital
- Orange, CA
- NPI 1689608150
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676937600000",
"number": "1407023922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 S MANCHESTER AVE STE 300",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683219",
"telephone_number": "714-456-2986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 THE CITY DR S",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683201",
"telephone_number": "714-880-7812"
}
],
"practiceLocations": [
{
"address_1": "10 Nathan D Perlman Pl",
"address_2": "Suite 12S34",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100033851",
"country_code": "US",
"telephone_number": "212-420-2124",
"fax_number": "212-420-3449",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "CARY",
"middle_name": "ALEXANDER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-14",
"last_updated": "2023-02-21",
"certification_date": "2023-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0101X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology",
"state": "CA",
"license": "C158492",
"primary": true
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "NY",
"license": "226610",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.