Individual provider Active NPI

Brian D. Johnson, MD

  • Emergency Medicine Physician
  • Oakland, CA
National Provider Identifier
1457652976
Registry record updated Oct 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A120102 Issued in CA
Practice address
275 W Macarthur
Oakland, CA 94611-5641
Phone
(510) 752-1000
NPI assigned
Nov 15, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A120102 CA Primary

Addresses

Primary practice location

275 W Macarthur
Oakland, CA 94611-5641

Mailing address

275 W Macarthur
Oakland, CA 94611-5641
Phone (510) 752-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20150615002626 WA Practitioner - Emergency Medicine 9335364512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Emory University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Emergency Room Physicians Inc PSGroup PAC ID 7911892054, 28 clinicians

Practice addresses (Care Compare)

400 S 43Rd St
Renton, WA 98055-5714
Phone (425) 228-3440

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
96.2
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
120102CAMDClinical Social Worker
A120102CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Emergency Room Physicians, Inc P.S. Emergency Medicine CurrentSince Jul 1, 2015 Accepting new patients

Locations

25246 Network Pl
Chicago, IL 60673

400 S 43rd St
Renton, WA 98055
Phone (425) 228-3450

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.

Hospital & facility affiliations 2

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": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413244800000",
    "number": "1457652976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 W MACARTHUR",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115641",
            "telephone_number": "510-752-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W MACARTHUR",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115641",
            "telephone_number": "510-752-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRIAN",
        "middle_name": "D.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-15",
        "last_updated": "2014-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A120102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.