Individual provider Active NPI

Cheilonda R Johnson, M.D.

  • Pulmonary Disease Physician
  • Philadelphia, PA
National Provider Identifier
1053367268
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD431679 Issued in PA
Practice address
3400 Civic Center Blvd FL 1
Philadelphia, PA 19104-5161
Phone
(215) 662-3202
Fax
(215) 349-8432
NPI assigned
May 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD431679 PA
Pulmonary Disease Physician 207RP1001X MD431679 PA Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD431679 PA

Addresses

Primary practice location

3400 Civic Center Blvd FL 1
Philadelphia, PA 19104-5161

Mailing address

3400 Civic Center Blvd FL 1
Philadelphia, PA 19104-5161
Phone (215) 662-3202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20070727000205 PA Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 9436250982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Perelman School of Med at the University of Pennsylvania, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St
FL 3
Philadelphia, PA 19104-4229
Phone (215) 662-3202

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD431679PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Internal Medicine Current Accepting new patients
University of Penn - Medical Group Past Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients

Locations

3400 Spruce St
Fl 3
Philadelphia, PA 19104

1800 Lombard St
Fl 1
Philadelphia, PA 19146
Phone (215) 893-2600

3400 Civic Center Blvd
Fl 1
Philadelphia, PA 19104
Phone (215) 615-5864

501 S 54th St
Philadelphia, PA 19143
Phone (215) 581-2046

3400 Convention Ave
Philadelphia, PA 19104
Phone (215) 662-2300

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

Organizations & group practices 3

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 5

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1053367268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD FL 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045161",
            "telephone_number": "215-662-3202",
            "fax_number": "215-349-8432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD FL 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045161",
            "telephone_number": "215-662-3202",
            "fax_number": "215-349-8432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHEILONDA",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD431679",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PA",
            "license": "MD431679",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "PA",
            "license": "MD431679",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.