Ilya Simone Johnson, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

ME79673 Issued in FL

Practice address

9595 N Kendall Dr
Suite 103
Miami, FL 33176-1979

Phone

(305) 279-8222

Fax

(305) 279-4096

NPI assigned

Jul 3, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Obstetrics/Gynecology

Education

Vanderbilt University School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vitalmd Group Holding LLCGroup PAC ID 8921091786, 535 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• South Miami Hospital Hospital, Miami, FL, CCN 100154
• Homestead Hospital Hospital, Homestead, FL, CCN 100125

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Vitalmd Group Holding LLC

  • Obstetrics & Gynecology Physician
  • Miami, FL
  • NPI 1871572032
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Homestead Hospital, Inc.

  dba Homestead Hospital

  • General Acute Care Hospital
  • Homestead, FL
  • NPI 1578547865
  Care Compare affiliation
• South Miami Hospital Inc

  • General Acute Care Hospital
  • South Miami, FL
  • NPI 1982688230
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154351567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9595 N KENDALL DR",
            "address_2": "SUITE 103",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761979",
            "telephone_number": "305-279-8222",
            "fax_number": "305-279-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9595 N KENDALL DR",
            "address_2": "SUITE 103",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761979",
            "telephone_number": "305-279-8222",
            "fax_number": "305-279-4096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ILYA",
        "middle_name": "SIMONE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME79673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Lynne Johnson, MD
• Deanna Louise Johnson
• Elizabeth Renee Johnson, M.D.
• Gail Johnson
• Gail Mary Johnson, RPT
• Jacqueline Johnson, AGNP
• John Johnson
• John Jefferson Johnson V, LAT, ATC
• Jonique Johnson, PHARMD, RPH, MTM
• Joshua Lynn Johnson

• Obstetrics & Gynecology Physician in Miami, FL
• Providers in Miami, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.