Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kevin Johnson

Individual provider Psychiatry Physician · NPI 1396155511

Kevin Johnson is a Psychiatry in Syracuse, New York. Graduated from Js Weill Medical College, Cornell University in 2014, 12 years ago. Practices as a sole proprietor, works from 2 locations and offers telehealth. Licensed in New York.

Years since qualifying
12
Trained at
Js Weill Medical College, Cornell University
Licensed in
NY
In the registry since
2014
Specialties on file
2
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Practice location Address checks out

1045 James St
Syracuse, NY 13203
Phone: (315) 472-4471
Fax: (315) 999-1377
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5016 W Genesee St, Camillus, NY 13031-2356 — (315) 320-7900

Specialties & licences

Addiction Medicine (Psychiatry & Neurology) Physician (primary) Taxonomy 2084A0401X · Licence 294176 (NY)
Psychiatry Physician Taxonomy 2084P0800X · Licence 294176 (NY)

Record details

NPI number1396155511
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 28, 2014
Last updated in NPPESSeptember 16, 2024
Certification dateSeptember 16, 2024
Mailing address129 Saddlestone Pl Apt A, Camillus, NY 13031-1688

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Also practisesADDICTION MEDICINE
Medical schoolJS WEILL MEDICAL COLLEGE, CORNELL UNIVERSITY
Graduated 2014 (12 years in practice)
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services

Other providers in Syracuse