Kyle Patrick Johnson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

57855 Issued in CA

Practice address

30 Mark West Springs Rd
Santa Rosa, CA 95403-1436

Phone

(707) 576-4040

NPI assigned

Mar 22, 2019

Last updated

Oct 31, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Kyle Patrick Johnson Professional name

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

Merit-based Incentive Payment System (MIPS)

Final score

96.69 of 100Reported as group

Quality

90

Improvement activities

40

Cost

78.43

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kjohnson545169@hisp.ehr.sutterhealth.org

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.

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• Nes Western Group, a Professional Corporation

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  Medicare reassignment
• San Francisco Emergency Medical Associates

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1134110661
  Medicare reassignment
• Sonoma Valley Emergency Physicians Medical Group, Inc

  • Emergency Medicine Physician
  • Sonoma, CA
  • NPI 1710164629
  Medicare reassignment
• Vallejo Emergency Physicians Medical Group Inc.

  • Emergency Medicine Physician
  • Vallejo, CA
  • NPI 1083916373
  Medicare reassignment
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • Daly City, CA
  • NPI 1922053438
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• Nes Western Group, a Professional Corporation

  • Emergency Medicine Physician
  • Hayward, CA
  • NPI 1588249569
  NPD

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1548720816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2351 CLAY ST STE 501",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941151931",
            "telephone_number": "866-898-7148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MARK WEST SPRINGS RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031436",
            "telephone_number": "707-576-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KYLE",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLE",
            "last_name": "JOHNSON",
            "middle_name": "PATRICK",
            "prefix": "MR.",
            "credential": "PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jerrmey D Johnson
• Jessica Johnson, RN
• Julie Ellen Johnson
• Julie Kay Johnson
• Kristen Johnson, M.D.
• Lois Christine Johnson, MD
• Lori Friedrich Johnson, NP
• Mercedes Chanel Johnson
• Michael Levon Johnson Jr.
• Natalie Sue Johnson, RN, PHN, CSN

• Physician Assistant in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.

Verify at the official NPI Registry.