NPIMap

Individual provider Active NPI

Michelle Rullan Johnson, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Cambridge, MA
National Provider Identifier
1114285905
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
265139 Issued in MA
Practice address
119 Windsor St
Cambridge, MA 02139-3647
Phone
(617) 665-3600
NPI assigned
Apr 30, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 265139 MA
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X 265139 MA Primary
Primary Care Clinic/Center 261QP2300X 265139 MA
Family Medicine Physician 207Q00000X 265139 MA

Addresses

Primary practice location

119 Windsor St
Cambridge, MA 02139-3647

Mailing address

10 Beacon St
Somerville, MA 02143-4311
Phone (617) 394-7703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161101002101 MA Practitioner - Geriatric MedicinePractitioner - Family Practice 6709001092 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Family Practice
Education
New York University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

119 Windsor St
Cambridge, MA 02139-3647
Phone (617) 665-3600

15 Railroad Ave
South Hamilton, MA 01982-2218
Phone (978) 468-7381

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.27 of 100Reported as group
Quality
77.51
Promoting interoperability
100
Improvement activities
40
Cost
76.72

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
265139MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission Multi-Specialty Current Accepting new patients
Cambridge Public Health Commission Multi-Specialty CurrentSince Sep 13, 2016 Accepting new patients
Beth Israel Lahey Health Primary Care Inc Multi-Specialty CurrentSince Dec 19, 2025 Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. Multi-Specialty CurrentSince Dec 19, 2025 Accepting new patients
Sancta Maria Hospital, Inc. Skilled Nursing Facility Past Accepting new patients
Stoneham Medical Group LLC Multi-Specialty Past Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. Multi-Specialty Past Accepting new patients
Neville Communities Home Inc Skilled Nursing Facility Past Accepting new patients
CRNC Operating LLC. Skilled Nursing Facility Past Accepting new patients

Locations

119 Windsor St
Cambridge, MA 02139
Phone (617) 665-3600

163 Gore St
East Cambridge, MA 02141
Phone (617) 499-6690

103 Garland St
Everett, MA 02149
Phone (617) 381-7150

10 Beacon St
Somerville, MA 02143
Phone (617) 665-3513

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

Interoperability endpoints

  • Direct secure messaging: mjohnson79428@direct.challiance.masshiway.net
  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4

Organizations & group practices 9

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 6

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": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1114285905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BEACON ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021434311",
            "telephone_number": "617-394-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 WINDSOR ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393647",
            "telephone_number": "617-665-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHELLE",
        "middle_name": "RULLAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-30",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "265139",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MA",
            "license": "265139",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MA",
            "license": "265139",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "265139",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.