DR. FREDERICK L JOHNSON (M.D.) – Anesthesiology Physician, NPI 1104983360

DR. FREDERICK L JOHNSON (M.D.) is a healthcare provider. based in Lakeport, California. specializing in ANESTHESIOLOGY. They hold the professional credentials M.D.. They hold a License No. A556180 (CA). The NPI Number for DR. FREDERICK L JOHNSON (M.D.) is 1104983360

Main info

Male
Sole Proprietor
37 Years Of Experience
Accepts Medicare Assignment
Name
DR. FREDERICK L JOHNSON (M.D.)
NPI
1104983360
Phone
(707) 263-7428
Address
987 PARALLEL DR
Enumeration Date
3 January 2007
Last Update Date
20 May 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2099521189
Graduation Year
1989 (37 years ago)
PAC ID
9234183450
Group Practice PAC ID
7719367093
Professional Enrollment ID
I20081122000047
Address ID
CA952075713ST36XXXAVEX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

6,371 ANESTHESIOLOGY in CA

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Provider Addresses for DR. FREDERICK L JOHNSON (M.D.)

  • 987, Parallel Drive, Lakeport, Lake County, California, 95453, United States

    LAKEPORT, CA 954535702

    Phone: (707) 263-7428

    Fax: (707) 263-7425

    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)

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: 2008-11-22

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
I20081122000047IAnesthesiologyCATBD

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
00790Anesthesia for other procedure on upper abdomen1616$0
36620Insertion of artery tube for blood sampling or infusion through skin1211$0
01230Anesthesia for procedure on upper 2/3rd of thigh bone1111$0
View full utilization report →

Insurance plans in this area (ZIP 95453)

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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: 7719367093View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YCA
A N E S T H E S I O L O G YCA
A N E S T H E S I O L O G YCA
A N E S T H E S I O L O G YCA
A N E S T H E S I O L O G YIL
Anesthesiology, Pain ManagementCA
A N E S T H E S I O L O G YCA
Anesthesiology, Pain ManagementCA
A N E S T H E S I O L O G YCA
A N E S T H E S I O L O G YCA

Reviews

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Frequently asked questions

How do payers reference DR. FREDERICK L JOHNSON (M.D.)?
For DR. FREDERICK L JOHNSON (M.D.), use NPI 1104983360 as the unique 10-digit identifier.
Is DR. FREDERICK L JOHNSON (M.D.) still an active registrant?
DR. FREDERICK L JOHNSON (M.D.) carries an active NPI according to the public dataset.
What clinical focus is listed for DR. FREDERICK L JOHNSON (M.D.)?
At a glance, DR. FREDERICK L JOHNSON (M.D.) is tied to Anesthesiology Physician. Clinical services aligned with this taxonomy classification.
Is DR. FREDERICK L JOHNSON (M.D.) located near Lakeport?
DR. FREDERICK L JOHNSON (M.D.) currently maps to Lakeport, California in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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