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JOHAN WINOTO M.D.
NPI 1780635920
Internal Medicine - Nephrology in Elk Grove, CA

Active since May 12, 2006PECOS EnrolledAccepts Medicare Assignment
2218 KAUSEN DR STE 103, ELK GROVE, CA 95758(916) 683-8774(916) 683-8777 Get Directions Write a Review

NPPES record last updated: June 13, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Johan Winoto M.d. NPPES

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

JOHAN WINOTO M.D. (NPI 1780635920) is an individual nephrology provider in Elk Grove, California, licensed in California (A116149) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS and is a graduate of Ohio State University College Of Medicine (2010).

NPPES Registry Identity

NPI1780635920
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameJOHAN WINOTOCredential: M.D.
Location Address2218 KAUSEN DR STE 103Elk Grove, CA 95758-7178
Mailing Address1111 Exposition Blvd Ste 300Sacramento, CA 95815-4324 · (916) 929-8564 · Fax (916) 929-4529
Phone(916) 683-8774
Fax(916) 683-8777
Sole ProprietorYes
Medical School CMSOhio State University College Of MedicineGraduated 2010
Enumeration DateMay 12, 2006
Last NPPES UpdateJune 13, 2025
NPPES CertifiedJune 13, 2025
✔ NPI 1780635920 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Licenses✔ Licensed in CA · A116149✔ Licensed in OH · 35090745
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
2218 KAUSEN DR STE 103, Elk Grove, CA 95758
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Other Identifiers 2

MedicaidGR0015060CA
OtherP00981485Railroad Medicare

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

Johan Winoto M.d. 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 ID5890702427
PECOS Enrollment IDI20110726000600
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 7

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.

Dialysis services, 2-3 physician visits per month (20 years or older) 90961
Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.
352 services53 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.
242 services157 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
177 services91 patients
Telephone medical discussion with physician, 21-30 minutes 99443
This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.
118 services80 patients
Dialysis services, 1 physician visit per month (20 years or older) 90962
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can’t do their job. A physician visit once a month ensures your treatment is working effectively and adjusts it if necessary. This service is available for individuals aged 20 years and older.
95 services32 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
61 services34 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95758 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
$137.20 typical visit price
range $60.44 – $180.85
Typical copayment $34.30 (range $15.11 – $45.21)
Most-billed visit code 99204
Established Patient
$105.95 typical visit price
range $19.88 – $148.15
Typical copayment $26.48 (range $4.97 – $37.03)
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.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
5 suppliers34 claims3,420 services$0.29 avg. paid by Medicare
Mycophenolate mofetil, oral, 250 mg J7517
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers28 claims3,420 services$0.16 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
5 suppliers33 claims33 services$16.03 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512
Treatment-Chemotherapy · category RH012N
5 suppliers29 claims30 services$12.18 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

JOHN HARRISON HOWARD III M.D.
Internal Medicine (Nephrology)
2218 KAUSEN DR STE 103
ELK GROVE, CA 95758
Sacramento County (916) 683-8774

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 Johan Winoto's NPI number?

The NPI number for Johan Winoto is 1780635920. It was assigned to this individual provider in the NPPES registry on May 12, 2006.

Where is Johan Winoto located?

Johan Winoto practices at 2218 Kausen Dr Ste 103, Elk Grove, CA 95758. The listed phone number is (916) 683-8774.

What is Johan Winoto's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Johan Winoto enrolled in Medicare?

Yes. Johan Winoto 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.

When was this NPI record last updated?

The NPPES record for Johan Winoto was last updated on June 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.