NPIMap

Individual provider Active NPI

Charles Johnson, D.O.

  • Family Medicine Physician
  • Hudson, NY
National Provider Identifier
1164520391
Registry record updated Dec 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
217292 Issued in NY
Practice address
949 Columbia St
Hudson, NY 12534-2624
Phone
(518) 828-7188
Fax
(518) 828-5049
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 217292 NY Primary

Addresses

Primary practice location

949 Columbia St
Hudson, NY 12534-2624

Mailing address

949 Columbia St
Hudson, NY 12534-2624
Phone (518) 828-7188

Other identifiers 1

IdentifierTypeStateIssuer
02103244MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20041021000850 NY Practitioner - Family PracticePractitioner - Emergency Medicine 7810958980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Memorial HospitalGroup PAC ID 5092709410, 171 clinicians

Practice addresses (Care Compare)

2827 US Route 9
Valatie, NY 12184-0785
Phone (518) 828-8051

4383 Route 23
Cairo, NY 12413-2680
Phone (518) 828-8066

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Memorial Hospital Past Accepting new patients
Fishkill Pharmacy LLC PastSince May 9, 2011 Accepting new patients
Adirondack Emergency Medicine, PC Past Accepting new patients
Mid-Hudson Family Health Institute Family Medicine Past Accepting new patients
Hudson Valley Hospitalists, PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cjohnson99435@albanymed.direct-ci.com

Organizations & group practices 6

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 8

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1164520391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 COLUMBIA ST",
            "city": "HUDSON",
            "state": "NY",
            "postal_code": "125342624",
            "telephone_number": "518-828-7188",
            "fax_number": "518-828-5049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 COLUMBIA ST",
            "city": "HUDSON",
            "state": "NY",
            "postal_code": "125342624",
            "telephone_number": "518-828-7188",
            "fax_number": "518-828-5049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHARLES",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "217292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02103244",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, NY

Sources for this page

Verify at the official NPI Registry.