Individual provider Active NPI

David Paul Johnson, M.D.

  • Vascular & Interventional Radiology Physician
  • Fort Myers, FL
National Provider Identifier
1053601229
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
ME130575 Issued in FL
Practice address
8791 Conference Dr
Fort Myers, FL 33919-5822
Phone
(239) 331-5566
Fax
(239) 247-5791
NPI assigned
Apr 8, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X MD0000049416 TN
Vascular & Interventional Radiology Physician 2085R0204X ME130575 FL Primary
Diagnostic Radiology Physician 2085R0202X MD00000049416 TN

Addresses

Primary practice location

8791 Conference Dr
Fort Myers, FL 33919-5822

Mailing address

8791 Conference Dr
Fort Myers, FL 33919-5822
Phone (239) 331-5566

Other practice location 1

1161 21st Ave S
D-4314 MCN
Nashville, TN 37232-2730
Phone (615) 343-6642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170627000505 FL Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 7113229915 Reassigns benefits to 4 organizations
I20260326000336 ID Practitioner - Diagnostic Radiology 7113229915 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Vanderbilt University School of Medicine, 2011
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Florida Radiology Consultants P aGroup PAC ID 3678471943, 70 clinicians
Sunshine Radiology Contracting LLCGroup PAC ID 0941771307, 9 clinicians
Florida Radiology Leasing LLCGroup PAC ID 1759327356, 39 clinicians

Practice addresses (Care Compare)

2776 Cleveland Ave
Fort Myers, FL 33901-5864
Phone (239) 938-3571

5431 Parker Dr
Fort Myers, FL 33919-2521
Phone (800) 475-3698

6311 S Pointe Blvd
Suite 600
Fort Myers, FL 33919-4901
Phone (239) 938-3500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.5 of 100Reported as group
Quality
80
Improvement activities
20

Merit-based Incentive Payment System (MIPS)

Final score
93.94 of 100Reported as group
Quality
100
Improvement activities
40
Cost
79.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00000049416TNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Florida Radiology Leasing LLC Diagnostic Radiology CurrentSince Jul 1, 2017 Accepting new patients
Sunshine Radiology Contracting LLC Diagnostic Radiology CurrentSince May 1, 2026 Accepting new patients
Florida Radiology Consultants P a Diagnostic Radiology CurrentSince Jul 1, 2017 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

636 Del Prado Blvd S
Ste 4
Cape Coral, FL 33990
Phone (239) 424-2318

636 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 332-5344

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

6311 S Pointe Blvd
Ste 600
Fort Myers, FL 33919
Phone (239) 343-9150

8192 College Pkwy
Ste 6
Fort Myers, FL 33919
Phone (239) 481-8022

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

Networks

  • Freedom Health HMO Network

Organizations & group practices 7

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": "1302220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1053601229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8791 CONFERENCE DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339195822",
            "telephone_number": "239-331-5566",
            "fax_number": "239-247-5791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8791 CONFERENCE DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339195822",
            "telephone_number": "239-331-5566",
            "fax_number": "239-247-5791"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1161 21st Ave S",
            "address_2": "D-4314 MCN",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372322730",
            "country_code": "US",
            "telephone_number": "615-343-6642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-08",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TN",
            "license": "MD0000049416",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "FL",
            "license": "ME130575",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "MD00000049416",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.