Deactivated NPI 1639260565 Deactivated / Inactive NPI Male Practitioner

Dr. Daclynn Johnson , MD

Surgery • Rupert, ID

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Daclynn Johnson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 27, 2006

NPI Deactivation Date October 06, 2023

Total Practice Duration ~17 Years of Practice (2006 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Daclynn Johnson, MD was a registered Surgery practicing in Rupert, ID. Throughout an active medical career spanning 17 years, Dr. Johnson provided care at the practice location at 1218 9TH ST STE 10 until profile deactivation on 2023-10-06.

Historical Medicare Part B clinical services included established patient outpatient office visit, new patient outpatient office visit, initial hospital inpatient care per day. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

1218 9th St Ste 10

Rupert, ID 833502207

Telephone 2084368340

Fax 2084363956

Associated Practice Facility / Clinic

🏢 Mini-Cassia Surgical Pc Facility NPI 1457656217

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Rupert, ID

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 12.0 Yrs

State Avg: 20.2 Yrs

Regional Practice Density

3 Specialists

Practicing in Rupert, ID (187 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

51.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2022)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	43	41	$176.00	$84.79

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	54	51	$168.85	$86.02
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	18	18	$241.89	$105.34
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	15	14	$115.87	$52.58

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	74	62	$165.81	$70.48
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	26	26	$227.08	$98.29
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	11	$110.00	$42.06

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	65	60	$149.62	$68.24
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	19	19	$214.21	$100.61
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	17	16	$99.41	$41.79
99202 New patient office or other outpatient visit, typically 20 minutes	12	12	$148.67	$71.04

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	67	62	$141.34	$63.14
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	42	39	$85.71	$38.24
99202 New patient office or other outpatient visit, typically 20 minutes	23	23	$143.30	$65.54
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	15	15	$206.40	$94.44

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	89	73	$82.67	$37.35
99213 Established patient office or other outpatient visit, typically 15 minutes	57	53	$136.32	$62.89
99202 New patient office or other outpatient visit, typically 20 minutes	20	20	$137.50	$64.42
99221 Initial hospital inpatient care per day, typically 30 minutes	11	11	$192.09	$87.77

Medical Specialties & State Licenses

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License ID M7497

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners

Dr. Brandon Beck , DO

Surgery

NPI 1528478294

Doctor of Osteopathic Medicine (D.O.)

Dr. Patrick Cindrich , MD

Neurological Surgery

NPI 1821101395

Doctor of Medicine (M.D.)

Casie Taylor , FNP

Nurse Practitioner - Family

NPI 1851635114

Family Nurse Practitioner

Dr. Ryan Callahan , DO

Orthopaedic Surgery

NPI 1962765222

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

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NPI Profile Deactivated October 06, 2023

Record deactivated on October 06, 2023

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NPI Profile Active May 18, 2012

NPI status registered as active in NPPES database

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Updated Practice Location May 18, 2012

Registered at 1218 9TH ST STE 10, RUPERT, ID 833502207 (Tel: 2084368340)

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Updated Business Mailing Address May 18, 2012

Registered at 1218 9TH ST STE 10, RUPERT, ID 833502207 (Tel: 2084368340)

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Provider Name / Credentials Updated May 18, 2012

Recorded as DACLYNN JOHNSON, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 18, 2012

Surgery (License #M7497 in ID)

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Initial NPI Registration & Enumeration September 27, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1639260565

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: September 27, 2006

Last Update: May 18, 2012

Deactivation Date: October 06, 2023

Update or Correct Profile

Mailing Address

1218 9th St Ste 10

Rupert, ID 833502207

Phone: 2084368340

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.