Individual provider Active NPI

Michael Johnson

  • Emergency Medicine Physician
  • Visalia, CA
National Provider Identifier
1962856716
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A15958 Issued in CA
Practice address
400 W Mineral King Ave
Visalia, CA 93291
Phone
(925) 998-7966
NPI assigned
Apr 18, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20A15958 CA Primary

Addresses

Primary practice location

400 W Mineral King Ave
Visalia, CA 93291

Mailing address

400 W Mineral King Ave
Visalia, CA 93291-6237
Phone (925) 998-7966

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
I20180822000327 CA Practitioner - Emergency Medicine 7810246022 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vituity-California Observation Services PCGroup PAC ID 5991178998, 83 clinicians
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians

Practice addresses (Care Compare)

1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone (916) 781-1000

Hospital & facility affiliations

  • Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
20A15958CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine CurrentSince Jul 1, 2018 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jul 1, 2018 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Vituity-California Observation Services PC Emergency Medicine CurrentSince Feb 1, 2023 Accepting new patients
Vituity-California Observation Services PC Emergency Medicine CurrentSince Feb 1, 2023 Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

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

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

869 N Cherry St
Tulare, CA 93274
Phone (559) 326-2800

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

Interoperability endpoints

  • Direct secure messaging: mjohnson457502@hisp.ehr.sutterhealth.org

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1962856716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W MINERAL KING AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916237",
            "telephone_number": "925-998-7966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W MINERAL KING AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "93291",
            "telephone_number": "925-998-7966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-18",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A15958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.