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TONICA VINETTA JOHNSON MD
NPI 1235177114
Ophthalmology in Durham, NC

Active since June 03, 2006PECOS EnrolledAccepts Medicare Assignment
67.14/100
CMS Quality Rating
1821 HILLANDALE RD 1B #300, DURHAM, NC 27706(216) 509-1814 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018, Sep 19, 2017 (3 updates tracked since 2017).

About Tonica Vinetta Johnson Md NPPES

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

TONICA VINETTA JOHNSON MD (NPI 1235177114) is an individual ophthalmology provider in Durham, North Carolina, licensed in North Carolina (200600411) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS, is affiliated with North Carolina Specialty Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1235177114
Entity TypeIndividualFemale
Primary Taxonomy207W00000X
Provider Legal NameTONICA VINETTA JOHNSONCredential: MD
Location Address1821 HILLANDALE RD 1B #300Durham, NC 27706
Mailing Address1821 Hillandale Rd 1b #300Durham, NC 27706 · (216) 509-1814
Phone(216) 509-1814
Sole ProprietorNo
Medical School CMSEmory University School Of MedicineGraduated 1999
Enumeration DateJune 3, 2006
Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration
✔ NPI 1235177114 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Licenses✔ Licensed in NC · 200600411✔ Licensed in CA · A87493
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Secondary Practice Locations 2

Location 11821 Hillandale Rd 1B #300Durham, NC 27706 · Phone (216) 509-1814
Location 24102 N Roxboro StDurham, NC 27704-2122 · Phone (919) 595-2000 · Fax (919) 595-2190

Other Identifiers 11

Other0800905NC · Mamsi
Medicaid5904044NC
Other0800905NC · Uhc
OtherOPH182NC · Primahealth
Other188041NC · Medcost
Other33400NC · Opticare
OtherP00340942Medicare Railroad
Other808293NC · Community Eye Care
Other142VKNC · Bcbs Nc
Other1326265NC · Aetna
Other808293NC · Partners

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, BlueCross BlueShield of Tennessee.Insurance ›

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

Tonica Vinetta Johnson Md 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 ID1658345608
PECOS Enrollment IDI20060801000240
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 8

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 low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
242 services109 patients
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.
199 services172 patients
Measurement of corneal curvature and depth of eye 92136
This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
74 services32 patients
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211
This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.
72 services55 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
66 services66 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
47 services37 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

North Carolina Specialty Hospital

Acute Care Hospitals · Durham, NC
OwnershipProprietary
CMS Certification Number340049
Location3916 Ben Franklin BoulevardDurham, NC 27704 · Durham County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27706 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
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.

67.14/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality63.32
Promoting Interoperability100
Improvement Activities40
Cost27.16

Reported Quality Measures

Advance Care Plan
36%662 patients2/55-star benchmark: 100%
Diabetes: Eye Exam
96%185 patients4/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
100%175 patients1/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
69%2,694 patients3/55-star benchmark: 100%
e-Prescribing
97%278 patients4/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 0% · 560 patients
0%560 patients
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
55%151 patients
Provide Patients Electronic Access to Their Health Information
84%449 patients4/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
77%189 patients4/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 712 patients
Patients totalRate: 0% · 712 patients
0%712 patients5/55-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.

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 Tonica Johnson's NPI number?

The NPI number for Tonica Johnson is 1235177114. It was assigned to this individual provider in the NPPES registry on June 3, 2006.

Where is Tonica Johnson located?

Tonica Johnson practices at 1821 Hillandale Rd 1B #300, Durham, NC 27706. The listed phone number is (216) 509-1814.

What is Tonica Johnson's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Tonica Johnson enrolled in Medicare?

Yes. Tonica 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.

What insurance does Tonica Johnson accept?

Health plans from Blue Cross and Blue Shield of NC and BlueCross BlueShield of Tennessee list Tonica 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.

Is Tonica Johnson affiliated with any hospitals?

According to CMS data, Tonica Johnson is affiliated with North Carolina Specialty Hospital.

When was this NPI record last updated?

The NPPES record for Tonica Johnson was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.