Active NPI
Adela Johnson, M.D.
- Pediatrics Physician
- East Meadow, NY
National Provider Identifier
1124089933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 117552
- Practice address
- 2201 Hempstead Tpke
East Meadow, NY 11554-1859 - Phone
- (516) 572-6177
- Fax
- (516) 572-5483
- NPI assigned
- Mar 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 117552 | NY | Primary |
Addresses
Primary practice location
2201 Hempstead Tpke
East Meadow, NY 11554-1859
Mailing address
2201 Hempstead Tpke
East Meadow, NY 11554-1859
Phone (516) 572-6177
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01962156 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 117552 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nassau Health Care Corporation | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- East Meadow, NY
- NPI 1730530940
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207785600000",
"number": "1124089933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2201 HEMPSTEAD TPKE",
"city": "EAST MEADOW",
"state": "NY",
"postal_code": "115541859",
"telephone_number": "516-572-6177",
"fax_number": "516-572-5483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2201 HEMPSTEAD TPKE",
"city": "EAST MEADOW",
"state": "NY",
"postal_code": "115541859",
"telephone_number": "516-572-6177",
"fax_number": "516-572-5483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "ADELA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-03-31",
"last_updated": "2008-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "117552",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01962156",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Meadow, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.