KEVIN JOHNSON
NPI 1396155511
Psychiatry & Neurology - Addiction Medicine in Syracuse, NY

Q: What is Kevin Johnson's NPI number?

The NPI number for Kevin Johnson is 1396155511. It was assigned to this individual provider in the NPPES registry on April 28, 2014.

Q: What is Kevin Johnson's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Addiction Medicine, with taxonomy code 2084A0401X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Johnson was last updated on September 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.

Active since April 28, 2014PECOS Enrolled

1045 JAMES STREET, SYRACUSE, NY 13203(315) 472-4471(315) 999-1377 Get Directions Write a Review

NPPES record last updated: September 16, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Sep 16, 2024, Aug 16, 2024, Mar 12, 2021 and 2 more (5 updates tracked since 2019).

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About Kevin Johnson NPPES

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

KEVIN JOHNSON (NPI 1396155511) is an individual addiction medicine provider in Syracuse, New York, licensed in New York (294176) and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS and is a graduate of Js Weill Medical College, Cornell University (2014).

NPPES Registry Identity

NPI1396155511

Entity TypeIndividualMale

Primary Taxonomy2084A0401X

Provider Legal NameKEVIN JOHNSON

Location Address1045 JAMES STREETSyracuse, NY 13203

Mailing Address129 Saddlestone Pl Apt ACamillus, NY 13031-1688 · (248) 914-8091

Phone(315) 472-4471

Fax(315) 999-1377

Sole ProprietorYes

Medical School CMSJs Weill Medical College, Cornell UniversityGraduated 2014

Enumeration DateApril 28, 2014

Last NPPES UpdateSeptember 16, 20245 updates tracked since enumeration

NPPES CertifiedSeptember 16, 2024

✔ NPI 1396155511 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Addiction MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2084A0401X

License✔ Licensed in NY · 294176

Definition

A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 294176 (NY)

1045 JAMES STREET, Syracuse, NY 13203

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Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kevin Johnson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5496067779

PECOS Enrollment IDI20190124003355

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

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.

81 services17 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13203 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

$126.40 typical visit price

range $54.87 – $166.88

Typical copayment $31.60 (range $13.71 – $41.72)

Most-billed visit code 99204

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

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.

Other Providers at the Same Location NPPES 9

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

ADRIENNE HALL LMSW

Social Worker