DR. CLAYTON GARY JOHNSEN (D.P.M.) – Foot & Ankle Surgery Podiatrist, NPI 1003141318

DR. CLAYTON GARY JOHNSEN (D.P.M.) is a healthcare provider. based in San bernardino, California. specializing in PODIATRY. They hold the professional credentials D.P.M.. They hold a License No. E4834 (CA). The NPI Number for DR. CLAYTON GARY JOHNSEN (D.P.M.) is 1003141318

Main info

Male
19 Years Of Experience
Accepts Medicare Assignment
Name
DR. CLAYTON GARY JOHNSEN (D.P.M.)
NPI
1003141318
Phone
(909) 886-3668
Address
1762 N WATERMAN AVE
Enumeration Date
5 October 2009
Last Update Date
20 June 2022

Doctor Profile

Medical School Name
NEW YORK COLLEGE OF PODIATRIC MEDICINE
Secondary Phone
-
Graduation Year
2007 (19 years ago)
PAC ID
1759512353
Group Practice PAC ID
6204122997
Professional Enrollment ID
I20140501002283
Address ID
CA924045130SA1762XAVEX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience70
Completeness75
Years active:16State licenses:2Digital endpointsOther names

1,833 PODIATRY in CA

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Provider Addresses for DR. CLAYTON GARY JOHNSEN (D.P.M.)

  • Waterman Avenue, San Bernardino, San Bernardino County, California, 92404, United States

    SAN BERNARDINO, CA 924045130

    Phone: (909) 886-3668

    Fax: (909) 886-5542

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $58.

Total Amount is formed as General ($58) + Research ($0) + Ownership ($0) = $58.

Last reported payment date: 2024-08-15 • Largest payer in this snapshot: Medtronic, Inc. ($27).

Total Amount

$58

General + Research + Ownership

Payments

3

Total payment records

General Amount

$58

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-15

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-05-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140501002283IPodiatryCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
11721Removal of fingernails or toenails, 6 or more nails1,001453$0
11056Removal of noncancer thickened skin growth, 2-4 growths917426$0
99213Established patient office or other outpatient visit, 20-29 minutes374130$0
99347Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes315170$0
99348Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes275127$0
View full utilization report →

Insurance plans in this area (ZIP 92404)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6204122997View full group profile
NameSpecialtyState
P O D I A T R YCA
P O D I A T R YCA
P O D I A T R YCA

Reviews

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Frequently asked questions

Can I use this page to confirm DR. CLAYTON GARY JOHNSEN (D.P.M.)'s NPI?
Yes. DR. CLAYTON GARY JOHNSEN (D.P.M.) is listed with NPI 1003141318 in the public NPI dataset.
Can I rely on DR. CLAYTON GARY JOHNSEN (D.P.M.) being an active provider?
As of the registry snapshot, DR. CLAYTON GARY JOHNSEN (D.P.M.) is marked active.
What is DR. CLAYTON GARY JOHNSEN (D.P.M.)'s specialty?
The listing groups DR. CLAYTON GARY JOHNSEN (D.P.M.) with Foot & Ankle Surgery Podiatrist. Clinical services aligned with this taxonomy classification.
Where should I expect DR. CLAYTON GARY JOHNSEN (D.P.M.) on a map?
Expect San Bernardino, California as a primary anchor for DR. CLAYTON GARY JOHNSEN (D.P.M.) unless the record lists multiple sites.
Why does DR. CLAYTON GARY JOHNSEN (D.P.M.) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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