BLAIR R JOHNSON (PA) – Medical Physician Assistant, NPI 1124082292

BLAIR R JOHNSON (PA) is a healthcare provider. based in Covina, California. specializing in Medical Physician Assistant. They hold the professional credentials PA. They hold a License No. PA11436 (CA). The NPI Number for BLAIR R JOHNSON (PA) is 1124082292

Main info

Male
43 Years Of Experience
Accepts Medicare Assignment
Name
BLAIR R JOHNSON (PA)
NPI
1124082292
Phone
(626) 331-6411
Address
420 W ROWLAND ST
Enumeration Date
14 April 2006
Last Update Date
14 October 2020

Doctor Profile

Medical School Name
UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Secondary Phone
3103160811
Graduation Year
1983 (43 years ago)
PAC ID
3971636440
Group Practice PAC ID
7315842002
Professional Enrollment ID
I20100804000555
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience74
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for BLAIR R JOHNSON (PA)

  • 420, West Rowland Street, Covina, Los Angeles County, California, 91723, United States

    COVINA, CA 917232943

    Phone: (626) 331-6411

    Fax: (626) 251-1560

    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: 2010-08-04

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
I20100804000555IPhysician AssistantCATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 91723)

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Provider's Procedures

BLAIR R JOHNSON (PA) performs procedures in Medical Physician Assistant. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICIAN ASSISTANTCA20610Aspiration and/or injection of large joint or joint capsule2218

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: 7315842002View full group profile
NameSpecialtyState
Internal MedicineCA
-CA
-CA
Family PracticeCA
-CA
-CA
Physical Therapist In Private PracticeNV
Internal MedicineCA
-CA
Internal Medicine, Geriatric MedicineCA

Reviews

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Frequently asked questions

What number should I use to identify BLAIR R JOHNSON (PA) for billing?
Administrative and clinical systems typically use NPI 1124082292 for BLAIR R JOHNSON (PA).
Does the public listing show BLAIR R JOHNSON (PA) as active?
BLAIR R JOHNSON (PA)'s NPI record reflects an active status in NPPES.
Which specialty label fits BLAIR R JOHNSON (PA)?
NPPES ties BLAIR R JOHNSON (PA) to Medical Physician Assistant in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to BLAIR R JOHNSON (PA)?
BLAIR R JOHNSON (PA) shows a connection to Covina, California in registry-derived data.
Can I export BLAIR R JOHNSON (PA)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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