Mr Mark L Johnson, PHD - Medicare Psychologist in Capitola, CA

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Mr Mark L Johnson, PHD is a medicare enrolled "Psychologist - Clinical" provider in Capitola, California. His current practice location is 4400 Capitola Rd Ste 200, Capitola, California. You can reach out to his office (for appointments etc.) via phone at (931) 426-9302.

Mr Mark L Johnson is licensed to practice in California (license number PSY27266) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1386904688.

Contact Information

Mr Mark L Johnson, PHD
4400 Capitola Rd Ste 200,
Capitola, CA 95010-3571
(931) 426-9302
(408) 378-4510

Map and Direction




Healthcare Provider's Profile

Full NameMr Mark L Johnson
GenderMale
SpecialityPsychologist - Clinical
Location4400 Capitola Rd Ste 200, Capitola, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1386904688
  • Provider Enumeration Date: 05/21/2012
  • Last Update Date: 07/27/2016
  Medicare PECOS Information:
  • PECOS PAC ID: 3072754647
  • Enrollment ID: I20160927000530

Medical Identifiers

Medical identifiers for Mr Mark L Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1386904688NPI-NPPES
PSY27266OtherCABOARD OF PSYCHOLOGY LICENSE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC0700XPsychologist - Clinical PSY27266 (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. Mr Mark L Johnson allows following entities to bill medicare on his behalf.
Entity NameIntegrated Pain Management Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1922198779
PECOS PAC ID: 0547252918
Enrollment ID: O20040402001211

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. Mr Mark L 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 AddressPractice Location Address
Mr Mark L Johnson, PHD
15047 Los Gatos Blvd Ste 200,
Los Gatos, CA 95032-2054

Ph: (408) 364-6799		Mr Mark L Johnson, PHD
4400 Capitola Rd Ste 200,
Capitola, CA 95010-3571

Ph: (931) 426-9302

Reviews and Comments


Psychologist in Capitola, CA

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Dr. Benjamin Corsbie, PSY.D.
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Practice Location: 4400 Capitola Rd Ste 200, Capitola, CA 95010
Phone: 831-426-9302    Fax: 831-426-9304
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Phone: 831-246-6554    

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