Individual provider Active NPI

Michael Johnson, M.D.

  • Internal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1083720817
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01034992 Issued in IN
Practice address
550 University Blvd
Uh 3005
Indianapolis, IN 46202-5149
Phone
(317) 944-2167
Fax
(317) 944-2305
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01034992 IN Primary

Addresses

Primary practice location

550 University Blvd
Uh 3005
Indianapolis, IN 46202-5149

Mailing address

250 N Shadeland Ave
Ste 130 Provider Enrollment
Indianapolis, IN 46219-4959

Other identifiers 1

IdentifierTypeStateIssuer
100098980MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mjohns17@direct.iuhealth.org

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
I20090325000787 IN Practitioner - Internal Medicine 4284791856 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Indiana University School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

  • Elara Caring Home health agency, Kokomo, IN, CCN 157586
  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056
  • Indiana University Health North Hospital Hospital, Carmel, IN, CCN 150161
  • Iu Health West Hospital Hospital, Avon, IN, CCN 150158

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01034992INMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Family Physicians, Inc. CurrentSince Apr 1, 2012 Accepting new patients
University Medical Diagnostic Associates, Inc. Internal Medicine CurrentSince Jan 3, 2012 Accepting new patients
University Family Physicians, Inc. Internal Medicine CurrentSince Apr 1, 2012 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jul 1, 2025 Accepting new patients
Major Hospital Past Accepting new patients

Locations

7301 Solutions Ctr
Chicago, IL 60677

7216 Solutions Ctr
Chicago, IL 60677

10300 N Illinois St
Ste 1000
Carmel, IN 46290
Phone (317) 817-1254

13000 E 136th St
Fishers, IN 46037
Phone (317) 678-2000

550 University Blvd
Ste 3100
Indianapolis, IN 46202
Phone (317) 962-8851

550 University Blvd
#3005
Indianapolis, IN 46202
Phone (317) 944-2167

250 N Shadeland Ave
Ste 200
Indianapolis, IN 46219
Phone (317) 962-4836

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

5515 W 38th St
Indianapolis, IN 46254
Phone (317) 880-3838

550 University Blvd
Indianapolis, IN 46202
Phone (217) 274-5000

720 Eskenazi Ave
Fl 5
Indianapolis, IN 46202
Phone (317) 880-6000

550 University Blvd
Ste UH3005
Indianapolis, IN 46202

250 University Blvd
Indianapolis, IN 46202
Phone (317) 274-8580

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

1001 W 10th St
Indianapolis, IN 46202
Phone (317) 630-6175

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1083720817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "address_2": "STE 130 PROVIDER ENROLLMENT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 UNIVERSITY BLVD",
            "address_2": "UH 3005",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025149",
            "telephone_number": "317-944-2167",
            "fax_number": "317-944-2305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01034992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100098980",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjohns17@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "550 University Blvd",
            "address_2": "UH 3005",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.