Active NPI
Russell Andrew Johnson, M.D.
- Emergency Medicine Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- A149593
- Practice address
- 100 UCLA Medical Plaza Suite 490
Los Angeles, CA 90095-1103 - Phone
- (310) 206-8000
- Fax
- (310) 206-8005
- NPI assigned
- Apr 9, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A149593 | CA | |
| Pediatrics Physician | 208000000X | A149593 | CA | |
| Emergency Medicine Physician | 207P00000X | A149593 | CA | Primary |
Addresses
Primary practice location
100 UCLA Medical Plaza Suite 490
Los Angeles, CA 90095-1103
Mailing address
5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
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
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1245 16TH St
Santa Monica, CA 90404-1240
1399 Roxbury Dr
Suite 100
Los Angeles, CA 90035-4709
Phone (310) 577-9896
2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2139
Phone (310) 458-2381
248 Hampshire Rd
Suite 100
Thousand Oaks, CA 91361-2401
Phone (805) 370-0040
514 N Prospect Ave
Redondo Beach, CA 90277-3036
Phone (310) 937-8555
Hospital & facility affiliations
- Santa Monica - UCLA Med Ctr & Orthopaedic Hospital
- Ronald Reagan UCLA Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A149593 | CA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Regents of the University of California | Internal Medicine | Current | Accepting new patients |
| The Regents of the University of California | Current | Accepting new patients | |
| UCLA Medical Group | Emergency Medicine | Past | Accepting new patients |
Locations
5767 W Century Blvd
#400
Los Angeles, CA 90045
100 UCLA Medical Plz
Ste 490
Los Angeles, CA 90024
Phone (310) 206-8000
5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200
File 55737
Los Angeles, CA 90074
1245 16th St
Ste 125
Santa Monica, CA 90404
Phone (310) 315-8900
2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381
Interoperability endpoints
- rjohnson606307@direct.uclahealth.org
- rjohnson753493@direct.ochin.org
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Los Angeles, CA
- NPI 1235107566
-
- Ambulatory Surgical Clinic/Center
- Valencia, CA
- NPI 1689200305
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Santa Monica, CA
- NPI 1427055839
-
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1902803315
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562630400000",
"number": "1497198402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD STE 400",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 UCLA MEDICAL PLAZA SUITE 490",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900951103",
"telephone_number": "310-206-8000",
"fax_number": "310-206-8005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "RUSSELL",
"middle_name": "ANDREW",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-04-09",
"last_updated": "2019-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A149593",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A149593",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "A149593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; 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.
- 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.