DR. JAMES ROBERT JOHNSON M.D.
NPI 1093864423
Family Medicine in San Clemente, CA

Active since January 08, 2007PECOS EnrolledAccepts Medicare Assignment
81.94/100
CMS Quality Rating
901 CALLE AMANECER, STE 100, SAN CLEMENTE, CA 92673(949) 218-1482(949) 218-1470 Get Directions Write a Review

NPPES record last updated: December 21, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. James Robert Johnson M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JAMES ROBERT JOHNSON M.D. (NPI 1093864423) is an individual family medicine provider in San Clemente, California, licensed in California (G69427) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS and is a graduate of Saint Louis University School Of Medicine (1989).

NPPES Registry Identity

NPI1093864423
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. JAMES ROBERT JOHNSONCredential: M.D.
Location Address901 CALLE AMANECER, STE 100San Clemente, CA 92673-6278
Mailing Address665 Camino De Los Mares 200San Clemente, CA 92673-2838 · (949) 429-6000 · Fax (949) 429-6001
Fax(949) 218-1470
Sole ProprietorYes
Medical School CMSSaint Louis University School Of MedicineGraduated 1989
Enumeration DateJanuary 8, 2007
Last NPPES UpdateDecember 21, 2015
NPI 1093864423 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in CA · G69427
Definition

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.

901 CALLE AMANECER, San Clemente, CA 92673

Other Identifiers 6

Medicare UPINF22693
Other260042944926730000Tricare
Medicare ID-Type UnspecifiedG69427
Other080183937Railroad Medicare
Other5422000G694270CA · Blue Shield
Other260042944CA · Blue Cross

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. James Robert Johnson M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5294908273
PECOS Enrollment IDI20111108000504
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 19

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
865 services316 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
377 services60 patients
Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457
This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.
375 services57 patients
Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454
This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.
374 services51 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
146 services146 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
143 services132 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92673 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.94/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality76.47
Promoting Interoperability100
Improvement Activities40
Cost63.33

Reported Quality Measures

Advance Care Plan
25%413 patients2/55-star benchmark: 100%
Appropriate Treatment for Upper Respiratory Infection (URI)
81%42 patients4/55-star benchmark: 100%
Breast Cancer Screening
41%271 patients2/55-star benchmark: 93%
Chlamydia Screening for Women
0%42 patients
Closing the Referral Loop: Receipt of Specialist Report
15%480 patients1/55-star benchmark: 87%
Colorectal Cancer Screening
19%871 patients1/55-star benchmark: 88%
Controlling High Blood Pressure
65%393 patients3/55-star benchmark: 91%
Diabetes: Eye Exam
1%69 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
99%69 patients1/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
99%4,209 patients4/55-star benchmark: 100%
e-Prescribing
99%2,746 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
0%393 patients1/55-star benchmark: 100%
HIV Screening
1%1,134 patients1/55-star benchmark: 60%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
55%1,402 patients3/55-star benchmark: 98%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
36%2,285 patients3/55-star benchmark: 61%
Provide Patients Electronic Access to Their Health Information
94%1,070 patients4/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
74%226 patients3/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 2% · 412 patients
Patients totalRate: 9% · 423 patients
9%423 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers16 claims32 services$6.36 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier15 claims15 services$62.26 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Home Health
901 CALLE AMANECER, SUITE 360
SAN CLEMENTE, CA 92673
Physical Therapy Assistant
901 CALLE AMANECER, SUITE 320
SAN CLEMENTE, CA 92673
Clinic/Center (Primary Care)
901 CALLE AMANECER, STE 100
SAN CLEMENTE, CA 92673
Physical Therapy Assistant
901 CALLE AMANECER
SAN CLEMENTE, CA 92673
Physical Therapy Assistant
901 CALLE AMANECER, SUITE 320
SAN CLEMENTE, CA 92673
Physical Therapist
901 CALLE AMANECER, STE 320
SAN CLEMENTE, CA 92673
Physical Therapist
901 CALLE AMANECER, STE 320
SAN CLEMENTE, CA 92673
Acupuncturist
901 CALLE AMANECER, SUITE 320
SAN CLEMENTE, CA 92673

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is James Johnson's NPI number?

The NPI number for James Johnson is 1093864423. It was assigned to this individual provider in the NPPES registry on January 8, 2007.

Where is James Johnson located?

James Johnson practices at 901 Calle Amanecer Ste 100, San Clemente, CA 92673. The listed phone number is (949) 218-1482.

What is James Johnson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is James Johnson enrolled in Medicare?

Yes. James Johnson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for James Johnson was last updated on December 21, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.