KENNETH JOHNSON (MD) – Emergency Medicine Physician, NPI 1033640933

KENNETH JOHNSON (MD) is a healthcare provider. based in Riverside, California. specializing in EMERGENCY MEDICINE. They hold the professional credentials MD. They hold a License No. A159476 (CA). The NPI Number for KENNETH JOHNSON (MD) is 1033640933

Main info

Male
Sole Proprietor
9 Years Of Experience
Accepts Medicare Assignment
Name
KENNETH JOHNSON (MD)
NPI
1033640933
Phone
(951) 235-7665
Address
9155 SANTA BARBARA DR
Enumeration Date
22 March 2017
Last Update Date
19 December 2019

Doctor Profile

Medical School Name
UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE
Secondary Phone
9094648666
Graduation Year
2017 (9 years ago)
PAC ID
4284065418
Group Practice PAC ID
9638334410
Professional Enrollment ID
I20200504000429
Address ID
CA917102609CH5451XAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:9State licenses:1Digital endpointsOther names

5,790 EMERGENCY MEDICINE in CA

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Provider Addresses for KENNETH JOHNSON (MD)

  • 9155, Santa Barbara Drive, Riverside, Riverside County, California, 92508, United States

    RIVERSIDE, CA 925086496

    Phone: (951) 235-7665

    Type: Mailing

  • Riverside Community Hospital, 4445, Magnolia Avenue, Riverside, Riverside County, California, 92501, United States

    RIVERSIDE, CA 925014135

    Phone: (951) 788-3537

    Fax: (951) 788-3173

    Type: Location

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: 2020-05-04

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
I20200504000429IEmergency MedicineCATBD

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
99285Emergency department visit with high level of medical decision making137136$0
99284Emergency department visit with moderate level of medical decision making124122$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only4845$0
99291Critical care, first 30-74 minutes3535$0
View full utilization report →

Insurance plans in this area (ZIP 92508)

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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: 9638334410View full group profile
NameSpecialtyState
Emergency MedicineCA
Emergency MedicineCA
Emergency MedicineCA
Emergency MedicineMI
Emergency MedicineHI
Emergency MedicineCA
Emergency MedicineCA
Emergency MedicineCA
Emergency MedicineCA
-CA

Reviews

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Frequently asked questions

What is the 10-digit NPI for KENNETH JOHNSON (MD)?
KENNETH JOHNSON (MD) — NPI 1033640933 — is the standard way to identify this listing.
Can I rely on KENNETH JOHNSON (MD) being an active provider?
As of the registry snapshot, KENNETH JOHNSON (MD) is marked active.
What healthcare role does KENNETH JOHNSON (MD) hold?
Scheduling teams often label KENNETH JOHNSON (MD) under Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What area does KENNETH JOHNSON (MD) serve?
KENNETH JOHNSON (MD)'s listing highlights Riverside, California; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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