Active NPI
Russell F Johnson, MD
- Radiation Oncology Physician
- Elkhart, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- 01039533
- Practice address
- 1215 Lawn Ave Ste 120
Elkhart, IN 46514-2450 - Phone
- (574) 523-2733
- Fax
- (574) 523-3251
- NPI assigned
- Sep 14, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | 01039533 | IN | Primary |
Addresses
Primary practice location
1215 Lawn Ave Ste 120
Elkhart, IN 46514-2450
Mailing address
3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-3725
Other practice location 1
621 Memorial Dr Ste 100
South Bend, IN 46601-1063
Phone (574) 647-1100
Other practice location 2
615 N Michigan St
South Bend, IN 46601-1087
Phone (574) 647-1100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200001710 | Medicaid | IN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rjohnson2@mybeacon.cernerdirect.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Radiation Oncology
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1215 Lawn Ave
Suite 120
Elkhart, IN 46514-2450
Phone (574) 523-2733
Hospital & facility affiliations
- Elkhart General Hospital
- Memorial Hospital of South Bend
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01039533 | IN | MD | Radiation Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beacon Medical Group Inc | Current | Accepting new patients | |
| Beacon Medical Group, Inc. | Radiation Oncology | Current | Accepting new patients |
| Beacon Medical Group, Inc. | Current | Accepting new patients | |
| Beacon Medical Group, Inc. | Past | Accepting new patients | |
| Radiology, Inc | Past | Accepting new patients |
Locations
1020 High Rd
#O
Bremen, IN 46506
Phone (574) 284-3086
1215 Lawn Ave
Ste 120
Elkhart, IN 46514
Phone (574) 523-2733
600 East Blvd
Elkhart, IN 46514
Phone (574) 294-2621
3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129
900 I St
Laporte, IN 46350
Phone (219) 324-1670
621 Memorial Dr
Ste 100
South Bend, IN 46601
Phone (574) 647-1100
710 N Niles Ave
South Bend, IN 46617
Phone (574) 647-1610
615 N Michigan St
South Bend, IN 46601
Phone (574) 647-1000
615 N Michigan St
Fl 1
South Bend, IN 46601
Phone (574) 647-1100
Networks
- devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
- IL HMO C-SNP
- OH PPO
- KY PPO C-SNP
- KY PPO
- IL PPO Downstate
- devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
Interoperability endpoints
- rjohnson2@mybeacon.cernerdirect.com
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Mishawaka, IN
- NPI 1033161617
-
- Anesthesiology Physician
- Elkhart, IN
- NPI 1437803285
-
- Radiation Oncology Physician
- South Bend, IN
- NPI 1770775009
-
- Orthopaedic Surgery Physician
- South Bend, IN
- NPI 1831149525
-
- Diagnostic Radiology Physician
- Mishawaka, IN
- NPI 1578557815
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Elkhart, IN
- NPI 1477551489
-
- General Acute Care Hospital
- South Bend, IN
- NPI 1295772093
-
- Psychiatric Hospital Unit
- South Bend, IN
- NPI 1376841395
-
- General Acute Care Hospital
- Granger, IN
- NPI 1881177756
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783987200000",
"number": "1003801283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3245 HEALTH DR STE 100",
"city": "GRANGER",
"state": "IN",
"postal_code": "465301380",
"telephone_number": "574-647-3725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1215 LAWN AVE STE 120",
"city": "ELKHART",
"state": "IN",
"postal_code": "465142450",
"telephone_number": "574-523-2733",
"fax_number": "574-523-3251"
}
],
"practiceLocations": [
{
"address_1": "621 Memorial Dr Ste 100",
"address_purpose": "LOCATION",
"city": "South Bend",
"state": "IN",
"postal_code": "466011063",
"country_code": "US",
"telephone_number": "574-647-1100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "615 N Michigan St",
"address_purpose": "LOCATION",
"city": "South Bend",
"state": "IN",
"postal_code": "466011087",
"country_code": "US",
"telephone_number": "574-647-1100",
"fax_number": "574-647-3148",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "RUSSELL",
"middle_name": "F",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-14",
"last_updated": "2026-07-14",
"certification_date": "2026-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "IN",
"license": "01039533",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200001710",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rjohnson2@mybeacon.cernerdirect.com",
"affiliation": "N",
"address_1": "621 Memorial Dr Ste 100",
"city": "South Bend",
"state": "IN",
"country_code": "US",
"postal_code": "466011063",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Elkhart, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.