MIRA MARIA JOHN (MD) – Critical Care Medicine (Internal Medicine) Physician, NPI 1013448588
Critical Care Medicine (Internal Medicine) Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
21,511 INTERNAL MEDICINE in CA
Provider Addresses for MIRA MARIA JOHN (MD)
FILE 57326
LOS ANGELES, CA 900747326
Phone: (800) 926-8273
Type: Mailing
9300 CAMPUS POINT DR
LA JOLLA, CA 920371300
Phone: (800) 926-8273
Type: Location
UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
1959 NE PACIFIC STREET, BOX 356522
SEATTLE, WA 98195
Phone: (206) 616-8378
Type: Mailing
1959 NE PACIFIC STREET
SEATTLE, WA 98195
Phone: (206) 616-8378
Type: Location
17 E 102nd St
New York, NY 100295204
Phone: (212) 659-8551
Type: Location
550 1st Ave
New York, NY 100166402
Phone: (212) 263-7300
Fax: (212) 263-6022
Type: Location
1959 NE Pacific Street
Seattle, WA 98195
Phone: (206) 616-8378
Type: Location
4011 Talbot Rd S Ste 460
Renton, WA 980555791
Phone: (425) 690-3484
Fax: (425) 690-9084
Type: Location
200 W Arbor Dr
San Diego, CA 921039000
Phone: (800) 926-8273
Type: Location
4520 Executive Dr
San Diego, CA 921213018
Phone: (800) 926-8273
Type: Location
Tisch Hospital, 550, 1st Avenue, Kips Bay, Manhattan Community Board 6, Manhattan, New York County, New York, 10016, United States
NEW YORK, NY 100166402
Phone: (212) 263-7300
Fax: (212) 263-6022
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2024-08-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230620000825 | I | Critical Care (Intensivists) | WA | TBD |
| I20240816001054 | I | Critical Care (Intensivists) | CA | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 90074)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | CA | |
| - | CA | |
| - | CA | |
| Surgical Oncology, General Surgery | MI | |
| - | CA | |
| - | CA | |
| - | CA | |
| - | CA | |
| Emergency Medicine, Medical Toxicology | CA | |
| Family Practice | CA |
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