NPI Details
DR. Gary Ronald Johnson, M.D. is a family medicine in San Andreas, CA with 53 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Gary Ronald Johnson, M.D. NPI is 1114013513. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
Education
Medical School: UNIVERSITY OF CALIFORNIA, SAN DIEGO SCHOOL OF MEDICINE
Graduation Year:1973
The provider's business location address is:
588 W. ST.CHARLES STREET
SAN ANDREAS, CA
ZIP 95249
Phone: (209) 754-1851
Fax: (209) 754-0231
The NPI 1114013513 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.
The CLIA number assigned to this NPI record is 05D0862377 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).
The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.
- Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
- Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
- Follow-up nursing facility visit per day, typically 35 minutes (HCPCS:99310)
- Injection of drug or substance under skin or into muscle (HCPCS:96372)
- Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes (HCPCS:99336)
- Initial nursing facility visit per day, typically 45 minutes (HCPCS:99306)
- Destruction of precancer skin growth, 2-14 growths (HCPCS:17003)
- Administration of influenza virus vaccine (HCPCS:G0008)
- Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
- Established patient custodial care facility, group care, or assisted living visit, typically 1 hour (HCPCS:99337)
- Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen (HCPCS:87635)
- New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
- Destruction of precancer skin growth, 1 growth (HCPCS:17000)
- New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
- Melanoma (skin cancer) excision (HCPCS:NAN03)
The enumeration date for this NPI number is 10/4/2006 and was last updated on 11/5/2024.
Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 208D00000X | General Practice | | G27755 | CALIFORNIA | No |
| 2 | 207Q00000X | Family Medicine | | G27755 | CALIFORNIA | Yes |
| 3 | 207R00000X | Internal Medicine | | G27755 | CALIFORNIA | No |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 00G277550 | MEDICAID | CALIFORNIA | |
