MR. MARK L JOHNSON PHD
NPI 1386904688
Psychologist - Clinical in Capitola, CA
About Mr. Mark L Johnson Phd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. MARK L JOHNSON PHD (NPI 1386904688) is an individual clinical provider in Capitola, California, licensed in California (PSY27266) and active in the NPI registry since May 2012. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mr. Mark L Johnson Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mark Johnson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Walnut Creek, CA 94598
- Reassigned Medicare billing, California enrollment
- 137 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 95010 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CAPITOLA, CA 95010
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 Mark Johnson's NPI number?
The NPI number for Mark Johnson is 1386904688. It was assigned to this individual provider in the NPPES registry on May 21, 2012.
Where is Mark Johnson located?
Mark Johnson practices at 4400 Capitola Rd Ste 200, Capitola, CA 95010. The listed phone number is (931) 426-9302.
What is Mark Johnson's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Mark Johnson enrolled in Medicare?
Yes. Mark Johnson is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Mark Johnson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mark Johnson reassigns Medicare benefits to Integrated Pain Management Medical Group, Inc. (Walnut Creek, CA). The 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 Mark Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mark Johnson was last updated on July 27, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Mr. Mark L Johnson, PHD · NPI 1386904688
Clinical provider in Capitola, California. Individual provider, active in the CMS NPPES registry since May 21, 2012.
## Identity
- **NPI:** 1386904688 (Entity type: Individual)
- **Enumerated:** May 21, 2012
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** PSY27266 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 4400 CAPITOLA RD STE 200, Capitola, CA 95010-3571
- **Phone:** (931) 426-9302 · **Fax:** (408) 378-4510
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for durable medical equipment
- **Bills Medicare through:** Integrated Pain Management Medical Group, Inc. (NPI 1922198779, Walnut Creek, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 27, 2016
- **Other identifiers:** Other PSY27266 (CA)
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Source: [NPI Profile](https://npiprofile.com/npi/1386904688) · Data from the CMS NPPES public registry.