NPIMap

Individual provider Active NPI

Johan Winoto, M.D.

  • Nephrology Physician
  • Elk Grove, CA
National Provider Identifier
1780635920
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A116149 Issued in CA
Practice address
2218 Kausen Dr Ste 103
Elk Grove, CA 95758-7178
Phone
(916) 683-8774
Fax
(916) 683-8777
NPI assigned
May 12, 2006
Last updated
Sep 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 35090745 OH
Nephrology Physician 207RN0300X A116149 CA Primary

Addresses

Primary practice location

2218 Kausen Dr Ste 103
Elk Grove, CA 95758-7178

Mailing address

1111 Exposition Blvd Ste 300
Sacramento, CA 95815-4324
Phone (916) 929-8564

Other identifiers 1

IdentifierTypeStateIssuer
GR0015060MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110726000600 CA Practitioner - Nephrology 5890702427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Ohio State University College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Capital Nephrology Medical GroupGroup PAC ID 5799736427, 22 clinicians

Practice addresses (Care Compare)

1111 Exposition Blvd
Suite 300
Sacramento, CA 95815-4324
Phone (916) 564-6232

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Nephrology Medical Group CurrentSince Jun 6, 2011 Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients

Locations

2218 Kausen Dr
Ste 103
Elk Grove, CA 95758
Phone (916) 683-8774

1665 Creekside Dr
Ste 100
Folsom, CA 95630
Phone (916) 235-7790

1111 Exposition Blvd
Ste 300
Sacramento, CA 95815
Phone (916) 564-6232

333 University Ave
Ste 120
Sacramento, CA 95825
Phone (916) 929-8564

Organizations & group practices 2

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1780635920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 EXPOSITION BLVD STE 300",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154324",
            "telephone_number": "916-929-8564",
            "fax_number": "916-929-4529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2218 KAUSEN DR STE 103",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587178",
            "telephone_number": "916-683-8774",
            "fax_number": "916-683-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINOTO",
        "first_name": "JOHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "35090745",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A116149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0015060",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

Verify at the official NPI Registry.