Individual provider Active NPI

Gadson John Johnson Jr., M.D.

  • Psychiatry Physician
  • Santa Monica, CA
National Provider Identifier
1578767232
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A100422 Issued in CA
Practice address
701 Santa Monica Blvd
Suite 230
Santa Monica, CA 90401-2623
Phone
(310) 993-4103
NPI assigned
Jun 14, 2007
Last updated
Mar 1, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A100422 CA Primary

Addresses

Primary practice location

701 Santa Monica Blvd
Suite 230
Santa Monica, CA 90401-2623

Mailing address

701 Santa Monica Blvd
Suite 230
Santa Monica, CA 90401-2623
Phone (310) 993-4103

Other identifiers 1

IdentifierTypeStateIssuer
00A100422MedicaidCA

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
I20090605000608 CA Practitioner - Psychiatry 3577631852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Un of California, Irvine, College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oceanside Medical Group a Medical CorporationGroup PAC ID 9335311042, 18 clinicians

Practice addresses (Care Compare)

701 Santa Monica Blvd
Suite 230
Santa Monica, CA 90401-2625
Phone (310) 993-4103

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A100422CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oceanside Medical Group, a Medical Corporation Psychiatry CurrentSince Jul 18, 2011 Accepting new patients
Culver City Psychological Associates, Inc. Past Accepting new patients
Tolwin Psychiatric Medical Group Inc Psychiatry PastSince Jan 1, 2009 Accepting new patients

Locations

1025 S Anaheim Blvd
Anaheim, CA 92805
Phone (714) 533-6220

3033 W Orange Ave
Anaheim, CA 92804
Phone (714) 229-5649

320 Cattle Call Dr
Brawley, CA 92227
Phone (760) 344-5431

17772 Beach Blvd
Huntington Beach, CA 92647
Phone (714) 842-1473

7901 Walker St
La Palma, CA 90623
Phone (562) 424-2900

2900 E Del Mar Blvd
Pasadena, CA 91107
Phone (310) 559-5916

1100 W Morton Ave
Porterville, CA 93257
Phone (559) 782-1509

701 Santa Monica Blvd
Ste 230
Santa Monica, CA 90401
Phone (310) 993-4103

44280 Campanula Way
Temecula, CA 92592
Phone (951) 302-1122

867 E 11th St
Upland, CA 91786
Phone (909) 227-0750

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1578767232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 SANTA MONICA BLVD",
            "address_2": "SUITE 230",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012623",
            "telephone_number": "310-993-4103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 SANTA MONICA BLVD",
            "address_2": "SUITE 230",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012623",
            "telephone_number": "310-993-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GADSON",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A100422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A100422",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.