Individual provider Active NPI

Daniel Steven Johnson, PA-C, L.AC.

  • Medical Physician Assistant
  • Watsonville, CA
National Provider Identifier
1508151572
Registry record updated May 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA21442 Issued in CA
Practice address
1505 Main St
Watsonville, CA 95076-3761
Phone
(831) 722-1444
Fax
(831) 722-4414
NPI assigned
Jun 17, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC 9587 CA
Medical Physician Assistant 363AM0700X PA21442 CA Primary

Addresses

Primary practice location

1505 Main St
Watsonville, CA 95076-3761

Mailing address

100 Wilson Rd Ste 100
Monterey, CA 93940-7885
Phone (831) 649-1000

Other practice location 1

4140 Jade St Ste 102
Capitola, CA 95010-3940
Phone (831) 464-7246

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110606000550 CA Practitioner - Physician Assistant 5294912960 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors on Duty Medical Group, IncGroup PAC ID 2466366703, 64 clinicians

Practice addresses (Care Compare)

1505 Main St
Watsonville, CA 95076-3761
Phone (831) 722-1444

3130 Del Monte Blvd
Marina, CA 93933-3047
Phone (831) 883-3330

615 Ocean St
Santa Cruz, CA 95060-4005
Phone (831) 425-7991

6800 Soquel Dr
Aptos, CA 95003-3225
Phone (831) 662-3611

Merit-based Incentive Payment System (MIPS)

Final score
85.47 of 100Reported as group
Quality
67.19
Promoting interoperability
100
Improvement activities
40
Cost
67.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
AC 9587CAMDAcupuncturist
PA21442CAMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: djohnson15191@direct.svmh.com

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525910400000",
    "number": "1508151572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WILSON RD STE 100",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939407885",
            "telephone_number": "831-649-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 MAIN ST",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950763761",
            "telephone_number": "831-722-1444",
            "fax_number": "831-722-4414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4140 Jade St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Capitola",
            "state": "CA",
            "postal_code": "950103940",
            "country_code": "US",
            "telephone_number": "831-464-7246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DANIEL",
        "middle_name": "STEVEN",
        "credential": "PA-C, L.AC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-17",
        "last_updated": "2018-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC 9587",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA21442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watsonville, CA

Sources for this page

Verify at the official NPI Registry.