Individual provider Active NPI

Russell F Johnson, MD

  • Radiation Oncology Physician
  • Elkhart, IN
National Provider Identifier
1003801283
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
01039533 Issued in IN
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

Updated by the provider on Jul 14, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
200001710MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051102000667 IN Practitioner - Radiation OncologyPractitioner - Diagnostic Radiology 7315965910 Reassigns benefits to 1 organization

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
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

1215 Lawn Ave
Suite 120
Elkhart, IN 46514-2450
Phone (574) 523-2733

Hospital & facility affiliations

  • Elkhart General Hospital Hospital, Elkhart, IN, CCN 150018
  • Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01039533INMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group Inc CurrentSince Feb 1, 2016 Accepting new patients
Beacon Medical Group, Inc. Radiation Oncology CurrentSince Feb 1, 2016 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.