Keena Johnson-bolden, FNP-BC - Medicare Nurse Practitioner in Los Angeles, CA

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Keena Johnson-bolden, FNP-BC is a medicare enrolled "Registered Nurse - Women's Health Care, Ambulatory" in Los Angeles, California. She graduated from nursing school in 2015 and has 10 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Southern California Permanente Medical Group and her current practice location is 400 W 30th St, Los Angeles, California. You can reach out to her office (for appointments etc.) via phone at (213) 284-3200.

Keena Johnson-bolden is licensed to practice in California (license number 95003776) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1780136820.

Contact Information

Keena Johnson-bolden, FNP-BC
400 W 30th St,
Los Angeles, CA 90007-3320
(213) 284-3200
Not Available

Map and Direction




Provider's Profile

Full NameKeena Johnson-bolden
GenderFemale
SpecialityNurse Practitioner
Experience10 Years
Location400 W 30th St, Los Angeles, California
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Keena Johnson-bolden graduated from nursing school in 2015
  NPI Data:
  • NPI Number: 1780136820
  • Provider Enumeration Date: 10/25/2016
  • Last Update Date: 08/07/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 1052734803
  • Enrollment ID: I20200713000710

Medical Identifiers

Medical identifiers for Keena Johnson-bolden such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1780136820NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163W00000XRegistered Nurse 634327 (California)Secondary
163WW0101XRegistered Nurse - Women's Health Care, Ambulatory 95003776 (California)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Southern California Permanente Medical Group60027291759038

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. Keena Johnson-bolden allows following entities to bill medicare on her behalf.
Entity NameSouthern California Permanente Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1770515280
PECOS PAC ID: 6002729175
Enrollment ID: O20031110000678
Entity NameMinuteclinic Diagnostic Medical Group Of California Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1033309372
PECOS PAC ID: 8224191374
Enrollment ID: O20090115000289
Entity NameMinuteclinic Diagnostic Medical Group Of Orange County Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1104013879
PECOS PAC ID: 5991868929
Enrollment ID: O20090116000214
Entity NameMinuteclinic Diagnostic Medical Group Of San Diego Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1568659233
PECOS PAC ID: 2567520414
Enrollment ID: O20090127000249
Entity NameMemorialcare Medical Foundation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1205167350
PECOS PAC ID: 8729277314
Enrollment ID: O20110113000219
Entity NameAgoura Hills Urgentocare Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1043840465
PECOS PAC ID: 3476981226
Enrollment ID: O20200310001981

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. Keena Johnson-bolden 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 AddressPractice Location Address
Keena Johnson-bolden, FNP-BC
400 W 30th St,
Los Angeles, CA 90007-3320

Ph: (213) 284-3200		Keena Johnson-bolden, FNP-BC
400 W 30th St,
Los Angeles, CA 90007-3320

Ph: (213) 284-3200

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.