Dr Sara Whitacre Johnson, MD is a medicare enrolled "Preventive Medicine - Public Health & General Preventive Medicine" physician in Redondo Beach, California. Her current practice location is
514 N Prospect Ave, Redondo Beach, California. You can reach out to her office (for appointments etc.) via phone at
(310) 937-8555.
Dr Sara Whitacre Johnson is licensed to practice in California (license number A117896) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1639450638.
Physician's Profile
| Full Name | Dr Sara Whitacre Johnson |
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| Gender | Female |
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| Speciality | Preventive Medicine - Public Health & General Preventive Medicine |
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| Location | 514 N Prospect Ave, Redondo Beach, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1639450638
- Provider Enumeration Date: 09/02/2011
- Last Update Date: 07/23/2020
Medicare PECOS Information:
- PECOS PAC ID: 9436472909
- Enrollment ID: I20171108003478
Medical Identifiers
Medical identifiers for Dr Sara Whitacre Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1639450638 | NPI | - | NPPES |
| 1639450638 | Medicaid | UT | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207P00000X | Emergency Medicine | A117896 (California) | Secondary |
| 207P00000X | Emergency Medicine | 9753A (Wyoming) | Secondary |
| 207P00000X | Emergency Medicine | 9022551-1205 (Utah) | Secondary |
| 2083P0901X | Preventive Medicine - Public Health & General Preventive Medicine | A117896 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Sara Whitacre Johnson allows following entities to bill medicare on her behalf.
| Entity Name | Faculty Physicians And Surgeons Of Llusm |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1205009917
PECOS PAC ID: 1153227814
Enrollment ID: O20031211000981 |
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| Entity Name | The Regents Of The University Of California |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1235107566
PECOS PAC ID: 1355248584
Enrollment ID: O20031223000439 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Sara Whitacre Johnson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Sara Whitacre Johnson, MD
5767 W Century Blvd Ste 400,
Los Angeles, CA 90045-5631
Ph: () - | Dr Sara Whitacre Johnson, MD
514 N Prospect Ave,
Redondo Beach, CA 90277-3036
Ph: (310) 937-8555 |
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