NPIMap

Individual provider Active NPI

Ann Michelle Johnson, MD

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1114978681
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD419327 Issued in PA
Practice address
3401 Civic Center Blvd
Children's Hospital of Philadelphia - Radiology
Philadelphia, PA 19104-4319
Phone
(215) 590-7000
Fax
(215) 590-9348
NPI assigned
May 12, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD419327 PA Primary

Addresses

Primary practice location

3401 Civic Center Blvd
Children's Hospital of Philadelphia - Radiology
Philadelphia, PA 19104-4319

Mailing address

100 E Penn SQ
9TH Floor
Philadelphia, PA 19107-3323
Phone (267) 425-9234

Other identifiers 1

IdentifierTypeStateIssuer
0019725690001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20031114000458 PA Practitioner - Diagnostic RadiologyPractitioner - Pediatric Medicine 0941114813 Reassigns benefits to 3 organizations
I20140812001459 NJ Practitioner - Diagnostic Radiology 0941114813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Michigan Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of Children's Hospital, IncGroup PAC ID 0345154399, 40 clinicians

Practice addresses (Care Compare)

100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 325-3000

3401 Civic Ctr Blvd
Philadelphia, PA 19104-4319
Phone (267) 425-9505

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
Geisinger Clinic Current Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst Diagnostic Radiology CurrentSince Jul 1, 2019 Accepting new patients
Geisinger Clinic Diagnostic Radiology CurrentSince Aug 5, 2018 Accepting new patients
Geisinger Clinic Diagnostic Radiology CurrentSince Aug 5, 2018 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Jul 1, 2019 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Current Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

3737 Market St
Philadelphia, PA 19104
Phone (215) 294-9393

250 King of Prussia Rd
Radnor, PA 19087
Phone (610) 902-1800

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1114978681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PENN SQ",
            "address_2": "9TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073323",
            "telephone_number": "267-425-9234",
            "fax_number": "267-425-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "CHILDREN'S HOSPITAL OF PHILADELPHIA - RADIOLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-7000",
            "fax_number": "215-590-9348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANN",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD419327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019725690001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.