Active NPI
Andrew W Johnson, MMS, PA-C
- Medical Physician Assistant
- Costa Mesa, CA
National Provider Identifier
1730778978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 59223
- Practice address
- 3151 Airway Ave Ste G1
Costa Mesa, CA 92626-4624 - Phone
- (714) 545-5550
- NPI assigned
- Jan 12, 2021
- Last updated
- Jan 8, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA59223 | CA | |
| Medical Physician Assistant | 363AM0700X | |||
| Surgical Physician Assistant | 363AS0400X | |||
| Medical Physician Assistant | 363AM0700X | 59223 | CA | Primary |
Addresses
Primary practice location
3151 Airway Ave Ste G1
Costa Mesa, CA 92626-4624
Mailing address
341 Monte Vista Ave
Costa Mesa, CA 92627-1460
Phone (619) 756-4112
Other practice location 1
3828 Delmas Ter
Culver City, CA 90232-2713
Phone (619) 756-4112
Other practice location 2
125 Baker St Unit 172
Costa Mesa, CA 92626-4556
Phone (619) 756-4112
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3151 Airway Ave
Suite G1
Costa Mesa, CA 92626-4624
Phone (714) 545-5550
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA59223 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Market Pharmacy LLC | Past | Accepting new patients | |
| Hoag Hospital | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- ajohnson@pnsi-ca.direct.office.nextgen.com
Organizations & group practices 4
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.
-
- Psychiatry Physician
- Costa Mesa, CA
- NPI 1356685218
-
- Adolescent Medicine (Internal Medicine) Physician
- Panorama City, CA
- NPI 1972624955
-
- General Acute Care Hospital
- Newport Beach, CA
- NPI 1689864365
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736294400000",
"number": "1730778978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "341 MONTE VISTA AVE",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926271460",
"telephone_number": "619-756-4112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3151 AIRWAY AVE STE G1",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926264624",
"telephone_number": "714-545-5550"
}
],
"practiceLocations": [
{
"address_1": "3828 Delmas Ter",
"address_purpose": "LOCATION",
"city": "Culver City",
"state": "CA",
"postal_code": "902322713",
"country_code": "US",
"telephone_number": "619-756-4112",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "125 Baker St Unit 172",
"address_purpose": "LOCATION",
"city": "Costa Mesa",
"state": "CA",
"postal_code": "926264556",
"country_code": "US",
"telephone_number": "619-756-4112",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "ANDREW",
"middle_name": "W",
"credential": "MMS, PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-01-12",
"last_updated": "2025-01-08",
"certification_date": "2025-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA59223",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "59223",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.