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KEVIN WAYNE JOHNSON DO
NPI 1104212562
Psychiatry & Neurology - Child & Adolescent Psychiatry in Tulsa, OK

Active since April 13, 2015PECOS EnrolledAccepts Medicare Assignment
4502 E 41ST ST, TULSA, OK 74135(918) 619-4400 Get Directions Write a Review

NPPES record last updated: June 12, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kevin Wayne Johnson Do NPPES

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

KEVIN WAYNE JOHNSON DO (NPI 1104212562) is an individual child & adolescent psychiatry provider in Tulsa, Oklahoma, licensed in Virginia (0102206028) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS and is a graduate of Oklahoma State University College Of Osteopathic Medicine (2015).

NPPES Registry Identity

NPI1104212562
Entity TypeIndividualMale
Primary Taxonomy2084P0804X
Provider Legal NameKEVIN WAYNE JOHNSONCredential: DO
Location Address4502 E 41ST STTulsa, OK 74135-2536
Mailing Address4502 E 41st StTulsa, OK 74135-2536
Phone(918) 619-4400
Sole ProprietorNo
Medical School CMSOklahoma State University College Of Osteopathic MedicineGraduated 2015
Enumeration DateApril 13, 2015
Last NPPES UpdateJune 12, 2020
NPPES CertifiedJune 12, 2020
✔ NPI 1104212562 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in VA · 0102206028
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 0102206028 (VA)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
4502 E 41ST ST, Tulsa, OK 74135
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kevin Wayne Johnson Do 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 ID7719256601
PECOS Enrollment IDI20200625002722
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Kevin Johnson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

City Of Portsmouth
1,091 mi
Community/Behavioral Health
1811 KING STREET
Portsmouth, VA 23704
  • Reassigned Medicare billing, Virginia enrollment
  • 11 clinicians in this Medicare group
NPI 1093891699 (757) 393-5404
Childrens Specialty Group PLLC
1,092 mi
Pediatrics
601 CHILDRENS LN
Norfolk, VA 23507
  • Reassigned Medicare billing, Virginia enrollment
  • 549 clinicians in this Medicare group
NPI 1255354130 (757) 668-7007

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

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 straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
80 services23 patients

Other Providers at the Same Location NPPES 20

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

MR. MICHAEL DANIEL FIGUEIREDO MD
Emergency Medicine
4502 E 41ST ST
TULSA, OK 74135
Tulsa County (918) 619-4400
PETER MADDEN MD
Internal Medicine
4502 E 41ST ST
TULSA, OK 74135
Tulsa County (918) 619-4400
AMNA OBAID
Student in an Organized Health Care Education/Training Program
4502 E 41ST ST
TULSA, OK 74135
Tulsa County (918) 619-4400
LAMAURI FRANKLIN
Student in an Organized Health Care Education/Training Program
4502 E 41ST ST
TULSA, OK 74135
Tulsa County (918) 660-3842
SAI ATLURI MD
Internal Medicine
4502 E 41ST ST
TULSA, OK 74135
Tulsa County (918) 619-4888
HAIDEN REECE PETERSON
Student in an Organized Health Care Education/Training Program
4502 E 41ST ST
TULSA, OK 74135
Tulsa County (918) 660-3842
RILEY SHULER POLK MD
Emergency Medicine
4502 E 41ST ST
TULSA, OK 74135
Tulsa County (918) 579-2367
DR. STEPHEN HODGES THOMAS MD
Emergency Medicine
4502 E 41ST ST
TULSA, OK 74135
Tulsa County (918) 660-3831

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 Kevin Johnson's NPI number?

The NPI number for Kevin Johnson is 1104212562. It was assigned to this individual provider in the NPPES registry on April 13, 2015.

Where is Kevin Johnson located?

Kevin Johnson practices at 4502 E 41st St, Tulsa, OK 74135. The listed phone number is (918) 619-4400.

What is Kevin Johnson's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Kevin Johnson enrolled in Medicare?

Yes. Kevin 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.

Which organizations bill Medicare for Kevin Johnson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Johnson reassigns Medicare benefits to 2 organizations: City Of Portsmouth (Portsmouth, VA) and Childrens Specialty Group PLLC (Norfolk, VA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kevin Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kevin Johnson accept?

Health plans from Oscar Health list Kevin Johnson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kevin Johnson was last updated on June 12, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.