Zachary Allen Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

55938 Issued in CA

Practice address

550 Deep Valley Dr Ste 283
Rolling Hills Estates, CA 90274-7602

Phone

(424) 235-6225

NPI assigned

Nov 10, 2018

Last updated

Nov 10, 2018By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Physician Assistant

Education

Kentucky University Medical Department, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Skin Surgery Center PAGroup PAC ID 3173599479, 72 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Skin Surgery Center PA

  dba The Skin Surgery Center of Charleston

  • MOHS-Micrographic Surgery Physician
  • Mount Pleasant, SC
  • NPI 1851810279
  Medicare reassignment Care Compare group NPD
• El Segundo Dermatology, Inc.

  dba Gardena Dermatology

  • Specialist
  • El Segundo, CA
  • NPI 1619351707
  NPD (past)
• Palos Verdes Skin Surgery Ctr Inc

  dba Palos Verdes Dermatology Surgery Center, Inc.

  • Ambulatory Surgical Clinic/Center
  • Rolling Hills Estates, CA
  • NPI 1285028803
  NPD (past)
• Skin Surgery Center PA

  • Dermatology Physician
  • Winston Salem, NC
  • NPI 1649237082
  NPD (past)

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

{
    "created_epoch": "1541808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541808000000",
    "number": "1598233256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 DEEP VALLEY DR STE 283",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902747602",
            "telephone_number": "424-235-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 DEEP VALLEY DR STE 283",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902747602",
            "telephone_number": "424-235-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ZACHARY",
        "middle_name": "ALLEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-10",
        "last_updated": "2018-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "55938",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kamron Izadi, MD
• Jack H Schnel Edd Abpp PC
• James H Flores Jr MD Inc (Peninsula Medica Group)
• Jennifer Chokemesil, LMFT, Marriage and Family Therapy Inc.
• Preeti Jhorar, M.D.
• Jonathan Lo D.D.S., Inc.
• Laura Jong, MD
• Jaeeun Jung, LAC
• Katrina Celeste Kaemmerer, D.O.
• Lauren Kai

• Physician Assistant in Rolling Hills Estates, CA
• Providers in Rolling Hills Estates, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2018; 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.