Kirk A Johnson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA 19261 Issued in CA

Practice address

1630 E Herndon Ave
Fresno, CA 93720-3305

Phone

(559) 256-5200

NPI assigned

Jul 24, 2007

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 identifiers 1

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

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Foundation Medical GroupGroup PAC ID 0345406294, 282 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fresno Surgical Hospital Hospital, Fresno, CA, CCN 050708
• Saint Agnes Medical Center Hospital, Fresno, CA, CCN 050093
• Community Regional Medical Center Hospital, Fresno, CA, CCN 050060
• San Joaquin Valley Rehabilitation Hosp Inpatient rehabilitation facility, Fresno, CA, CCN 053032

Merit-based Incentive Payment System (MIPS)

Final score

90.41 of 100Reported as group

Quality

87.02

Promoting interoperability

100

Improvement activities

40

Cost

78.21

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kirk.johnson.p1@direct.spocortho.nextgenshare.com

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.

• Community Foundation Medical Group

  dba Sante' Foundation Medical Group

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1811258510
  Medicare reassignment Care Compare group NPD
• Sierra Pacific Orthopaedic Center Medical Group, Inc.

  • Specialist
  • Fresno, CA
  • NPI 1285669655
  Medicare reassignment NPD
• Community Foundation Medical Group

  dba Sante' Foundation Medical Group

  • Orthopaedic Surgery Physician
  • Fresno, CA
  • NPI 1376056721
  NPD
• Fresno Surgery Center LP

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1205834694
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• 7173 North Sharon Avenue Operating Company, LLC

  dba San Joaquin Valley Rehabilitation Hospital

  • Rehabilitation Hospital
  • Fresno, CA
  • NPI 1831144716

  Inpatient rehabilitation facility

  Care Compare affiliation
• Fresno Community Hospital and Medical Center

  dba Community Regional Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1104906569
  Care Compare affiliation
• Fresno Surgery Center LP

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1205834694
  Care Compare affiliation
• Saint Agnes Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1205845567
  Care Compare affiliation

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210032000000",
    "number": "1700086949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 E HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203305",
            "telephone_number": "559-256-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 E HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203305",
            "telephone_number": "559-256-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KIRK",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-24",
        "last_updated": "2008-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 19261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00442770",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Johnson
• Kerry Lynn Johnson, RDN
• Keshon Lorenzo Johnson
• Kevel Ivonda Johnson, M.S., MFTI
• Kingman Rush Johnson
• Lauren Renee-Mary Johnson, FNP-C
• Lillie Lois Johnson
• Logan James Johnson
• Mackenzie Walter Johnson
• Michelle Rene Johnson, MA

• Physician Assistant in Fresno, CA
• Providers in Fresno, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.