Individual provider Active NPI

Johnny Negusse, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1881845485
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
FN2058623 Issued in TX
Practice address
8221 Rochester Ave Ste 130
Rancho Cucamonga, CA 91730-0721
Phone
(330) 353-1659
NPI assigned
Oct 2, 2008
Last updated
Nov 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X FN2058623 TX Primary

Addresses

Primary practice location

8221 Rochester Ave Ste 130
Rancho Cucamonga, CA 91730-0721

Mailing address

8221 Rochester Ave Ste 130
Rancho Cucamonga, CA 91730-0721
Phone (330) 353-1659

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
I20130703000509 CA Practitioner - Emergency Medicine 1355475062 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Current Accepting new patients
Nebi PC CurrentSince Oct 1, 2021 Accepting new patients
Cep America - California CurrentSince May 1, 2013 Accepting new patients
Cep America-California CurrentSince May 1, 2013 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

255 E Bonita Ave
Pomona, CA 91767
Phone (866) 724-4127

8221 Rochester Ave
Ste 130
Rch Cucamonga, CA 91730
Phone (609) 497-7662

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24495/brand/1/csg/1/fhir/r4

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Community Hospital of San BernardinoSan Bernardino, CA, CCN 050089 Hospital Corporate Director Jan 1, 2018
San Bernardino Community HospitalSan Bernardino, CA, CCN 05S089 Hospital Corporate Director Jan 1, 2018
Community Hospital of San BernardinoSan Bernardino, CA, CCN 555522 Skilled nursing facility Corporate Director Jan 1, 2018
Community Convalescent Center of San BernardinoSan Bernardino, CA, CCN 056107 Skilled nursing facility Corporate Director Jan 1, 2018

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

NPI Registry JSON

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1881845485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8221 ROCHESTER AVE STE 130",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917300721",
            "telephone_number": "330-353-1659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8221 ROCHESTER AVE STE 130",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917300721",
            "telephone_number": "330-353-1659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEGUSSE",
        "first_name": "JOHNNY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-02",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "FN2058623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.