Individual provider Active NPI

Russell Andrew Johnson, M.D.

  • Emergency Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1497198402
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A149593 Issued in CA
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

Updated by the provider on Jul 9, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171016002757 CA Practitioner - Emergency MedicinePractitioner - Internal MedicinePractitioner - Pediatric Medicine 4880916063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Internal Medicine, Pediatric Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Regents of the University of CaliforniaGroup PAC ID 1355248584, 1,426 clinicians

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 Hospital, Santa Monica, CA, CCN 050112
  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A149593CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California Internal Medicine CurrentSince Feb 1, 2018 Accepting new patients
The Regents of the University of California CurrentSince Feb 1, 2018 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

  • Direct secure messaging: rjohnson606307@direct.uclahealth.org
  • Direct secure messaging: 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.

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": "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

Verify at the official NPI Registry.