DR. GARY RONALD JOHNSON M.D.
NPI 1114013513
General Practice in San Andreas, CA


Quality Rating: 60 out of 100 score

NPI Status: Active since October 04, 2006

Contact Information

588 W. ST.CHARLES STREET
SAN ANDREAS, CA
ZIP 95249
Phone: (209) 754-1851
Fax: (209) 754-0231

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  • Individual
  • Male
  • Years of Experience 51
  • General Practice
  • PECOS Enrolled
  • Accepts Medicare Approved Payment
  • CLIA Number: 05D0862377
  • CLIA Cert. Type: PPMP
  • CLIA Exp. Date: 08-31-2024

About GARY JOHNSON

Gary Johnson is a primary care provider established in San Andreas, California and his medical specialization is General Practice with more than 51 years of experience. He graduated from University Of California, San Diego School Of Medicine in 1973. The healthcare provider is registered in the NPI registry with number 1114013513 assigned on October 2006. The practitioner's primary taxonomy code is 208D00000X with license number G27755 (CA). The provider is registered as an individual and his NPI record was last updated 10 years ago.

NPI
1114013513
Provider Name
DR. GARY RONALD JOHNSON M.D.
Gender
Male
Entity Type
Individual
Location Address
588 W. ST.CHARLES STREET SAN ANDREAS, CA 95249
Location Phone
(209) 754-1851
Location Fax
(209) 754-0231
Mailing Address
PO BOX 580 SAN ANDREAS, CA 95249
Mailing Phone
(209) 754-1851
Mailing Fax
(209) 754-0231
Medical School Name
UNIVERSITY OF CALIFORNIA, SAN DIEGO SCHOOL OF MEDICINE
Graduation Year
1973
Is Sole Proprietor?
Yes
Enumeration Date
10-04-2006
Last Update Date
03-07-2014
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A primary care provider (PCP) like Gary Johnson sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Gary Johnson is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 60, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

General Practice

Taxonomy Code
208D00000X
Type
Allopathic & Osteopathic Physicians
License No.
G27755
License State
CA
Taxonomy Description
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Medicare

  • Medicaid


*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
A43483MEDICARE UPIN (02)CA 
ZZZ01445ZMEDICARE ID-TYPE UNSPECIFIED (04)CA 
00G277550MEDICAID (05)CA 

PECOS Enrollment and Medicare Participation Status

Gary Johnson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 3971540162

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20050411000674

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • Other DME (D1E)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    7 DME suppliers used 31 Medicare Claims 66 Services Paid

  • Other DME (D1E)

    Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)

    5 DME suppliers used 14 Medicare Claims 14 Services Paid

  • Other DME (D1E)

    Administration set, with small volume nonfiltered pneumatic nebulizer, disposable (HCPCS:A7003)

    3 DME suppliers used 20 Medicare Claims 40 Services Paid

  • Other DME (D1E)

    Cushion for use on nasal mask interface, replacement only, each (HCPCS:A7032)

    3 DME suppliers used 11 Medicare Claims 66 Services Paid

  • Other DME (D1E)

    Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)

    3 DME suppliers used 18 Medicare Claims 18 Services Paid

  • Other DME (D1E)

    Headgear used with positive airway pressure device (HCPCS:A7035)

    5 DME suppliers used 14 Medicare Claims 14 Services Paid

  • Other DME (D1E)

    Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

    6 DME suppliers used 24 Medicare Claims 144 Services Paid

  • Other DME (D1E)

    Filter, non disposable, used with positive airway pressure device (HCPCS:A7039)

    4 DME suppliers used 12 Medicare Claims 12 Services Paid

  • Hospital beds (D1B)

    Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress (HCPCS:E0295)

    1 DME suppliers used 21 Medicare Claims 21 Services Paid

  • Oxygen and supplies (D1C)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    4 DME suppliers used 60 Medicare Claims 60 Services Paid

  • Other DME (D1E)

    Nebulizer, with compressor (HCPCS:E0570)

    2 DME suppliers used 12 Medicare Claims 12 Services Paid

  • Oxygen and supplies (D1C)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    5 DME suppliers used 56 Medicare Claims 56 Services Paid

  • Drugs Administered through DME (D1G)

    Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme (HCPCS:J7620)

    3 DME suppliers used 27 Medicare Claims 2460 Services Paid

  • Wheelchairs (D1D)

    Standard wheelchair (HCPCS:K0001)

    2 DME suppliers used 13 Medicare Claims 13 Services Paid

Drugs and Nutritional Products

  • Enteral and parenteral (O1C)

    Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape (HCPCS:B4035)

    3 DME suppliers used 22 Medicare Claims 640 Services Paid

  • Enteral and parenteral (O1C)

    Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit (HCPCS:B4150)

    2 DME suppliers used 26 Medicare Claims 9274 Services Paid

  • Other drugs (O1E)

    Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)

    5 DME suppliers used 33 Medicare Claims 33 Services Paid

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 60 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: N/A

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: N/A

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: N/A

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Clinician Services

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 130

    Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)

  • 106

    Administration of influenza virus vaccine (HCPCS:G0008)

  • 94

    Vaccine for influenza for injection into muscle (HCPCS:90662)

  • 70

    Destruction of 2-14 skin growths (HCPCS:17003)

  • 29

    Destruction of skin growth (HCPCS:17000)

  • 25

    Administration of pneumococcal vaccine (HCPCS:G0009)

  • 14

    Urinalysis, manual test (HCPCS:81002)

Hospital Affiliations

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Gary Johnson is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
SUTTER AMADOR HOSPITAL200 MISSION BLVD
JACKSON, CA 95642
(209) 223-7500Acute Care Hospitals
SUTTER MEDICAL CENTER, SACRAMENTO2825 CAPITOL AVENUE
SACRAMENTO, CA 95816
(916) 733-8999Acute Care Hospitals
ADVENTIST HEALTH SONORA1000 GREENLEY ROAD
SONORA, CA 95370
(209) 536-5000Acute Care Hospitals
MARK TWAIN MEDICAL CENTER768 MOUNTAIN RANCH RD
SAN ANDREAS, CA 95249
(209) 754-2515Critical Access Hospitals

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D0862377
Facility Type
Physician Office
Certificate Effective Date
September 01, 2022
Certificate Expiration Date
August 31, 2024
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Gary Johnson in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1114013513
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
212401652
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 2 + 4 + 0 + 1 + 6 + 5 + 2 + 24 = 47
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 47 = 33

The NPI number 1114013513 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1114013513, enumerated in the NPI registry as an "individual" on October 04, 2006

The provider is located at 588 W. St.charles Street San Andreas, Ca 95249 and the phone number is (209) 754-1851

The provider's speciality is General Practice with taxonomy code 208D00000X

The provider has more than 51 years of experience. He graduated from University Of California, San Diego School Of Medicine in 1973.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 11, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The most common procedures or services performed by this practitioner are: Injection beneath the skin or into muscle for therapy, diagnosis, or prevention, Administration of influenza virus vaccine, Vaccine for influenza for injection into muscle, Destruction of 2-14 skin growths, Destruction of skin growth, Administration of pneumococcal vaccine and Urinalysis, manual test.

The provider's CLIA number is 05D0862377 for a "physician office" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..

The practitioner is affiliated to the following hospital(s): SUTTER AMADOR HOSPITAL, SUTTER MEDICAL CENTER, SACRAMENTO, ADVENTIST HEALTH SONORA and MARK TWAIN MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on October 04, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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