Individual provider Active NPI

Ronald M Johnson, MD

  • Surgery Physician
  • La Mesa, CA
National Provider Identifier
1477672046
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G19831 Issued in CA
Practice address
5360 Jackson Drive
Ste 100
La Mesa, CA 91943
Phone
(619) 462-5900
Fax
(619) 462-9899
NPI assigned
Mar 28, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G19831 CA Primary

Addresses

Primary practice location

5360 Jackson Drive
Ste 100
La Mesa, CA 91943

Mailing address

PO Box 2507
La Mesa, CA 91943-2507
Phone (619) 462-5900

Other identifiers 1

IdentifierTypeStateIssuer
00G19831MedicaidCA

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
I20040526001311 CA Practitioner - General Surgery 5890689855 Reassigns benefits to 1 organization
Practice locations: La Mesa, CA

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5555 Grossmont Ctr Dr
La Mesa, CA 91942-3019
Phone (619) 244-0884

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement11
Spinal fusion68
Laminectomy or laminotomy (partial removal of spine bones)75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency and Acute Care Medical Corporation CurrentSince Apr 23, 2019 Accepting new patients
Scripps Health Current Accepting new patients

Locations

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

Interoperability endpoints

  • Direct secure messaging: rjohnson81160@scrippshlth.medalliesdirect.net

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, 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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477672046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2507",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919432507",
            "telephone_number": "619-462-5900",
            "fax_number": "619-462-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5360 JACKSON DRIVE",
            "address_2": "STE 100",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "91943",
            "telephone_number": "619-462-5900",
            "fax_number": "619-462-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RONALD",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G19831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G19831",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.