VICTORIA LECORIAN JOHNSON (M.D.) – Psychiatry Physician, NPI 1083094791
Psychiatry Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for VICTORIA LECORIAN JOHNSON (M.D.)
1713 6TH AVENUE SOUTH
CPM C7
BIRMINGHAM, AL 352330018
Phone: (205) 996-6633
Fax: (205) 975-7406
Type: Mailing
15100 Mack Ave
Grosse Pointe Park, MI 482306202
Phone: (313) 824-4400
Type: Location
725 Welch Rd
Palo Alto, CA 943041601
Phone: (650) 497-8000
Type: Location
906 Main Ave
Tillamook, OR 971413816
Phone: (503) 842-8201
Type: Location
804 FAIRVIEW LN APT 2
FORT LEE, NJ 070241568
Phone: (478) 719-7682
Fax: (551) 236-2513
Type: Mailing
500 W 148TH ST APT 4G
NEW YORK, NY 100314118
Phone: (478) 719-7682
Fax: (205) 975-7406
Type: Mailing
134 N 4TH ST
BROOKLYN, NY 112493296
Phone: (646) 450-7748
Fax: (718) 481-2061
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: 2024-01-04
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 |
|---|---|---|---|---|
| I20220218000830 | I | Psychiatry | NY | TBD |
| I20240104002246 | I | Psychiatry | IL | 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 35233)
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