Individual provider Active NPI

Brad Nathan Johnson, DO

  • Anesthesiology Physician
  • Lansing, MI
National Provider Identifier
1174595730
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
BS015087 Issued in MI
Practice address
405 W Greenlawn Ave
#106
Lansing, MI 48910-2898
Phone
(517) 482-2118
Fax
(517) 482-6280
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X BS015087 MI Primary

Addresses

Primary practice location

405 W Greenlawn Ave
#106
Lansing, MI 48910-2898

Mailing address

405 W Greenlawn Ave
#106
Lansing, MI 48910-2898
Phone (517) 482-2118

Other identifiers 1

IdentifierTypeStateIssuer
4723010MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20050405001325 MI Practitioner - Anesthesiology 7113974767 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Michigan State University College of Osteopathic Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial HospitalGroup PAC ID 8527976497, 210 clinicians

Practice addresses (Care Compare)

3337 Britton Rd
Perry, MI 48872-9706
Phone (517) 625-3004

826 W King St
Owosso, MI 48867-2120

Hospital & facility affiliations

  • Memorial Healthcare Hospital, Owosso, MI, CCN 230121

Merit-based Incentive Payment System (MIPS)

Final score
82.58 of 100Reported as group
Quality
58.15
Promoting interoperability
100
Improvement activities
40
Cost
74.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BS015087MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Anesthesiology CurrentSince Jul 1, 2024 Accepting new patients
Memorial Hospital Anesthesiology CurrentSince Jul 1, 2024 Accepting new patients
Northstar Anesthesia of Michigan III PLLC CurrentSince Aug 30, 2021 Accepting new patients
Northstar Anesthesia of Michigan II PC Anesthesiology CurrentSince Jun 1, 2013 Accepting new patients
B & C Anesthesia Services LLC Past Accepting new patients
Capital Area Anesthesia PC PastSince Aug 1, 2021 Accepting new patients

Locations

9000 Peet Rd
Chesaning, MI 48616
Phone (989) 720-2273

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

1090 Trowbridge Rd
Ste A
East Lansing, MI 48823
Phone (517) 220-0240

3400 E Jolly Rd
Lansing, MI 48910
Phone (517) 272-1063

1707 Lake Lansing Rd
Lansing, MI 48912
Phone (517) 267-0033

26750 Providence Pkwy
Ste 100
Novi, MI 48374
Phone (248) 662-1500

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

3337 Britton Rd
Perry, MI 48872
Phone (517) 625-3004

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

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 1

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1174595730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W GREENLAWN AVE",
            "address_2": "#106",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489102898",
            "telephone_number": "517-482-2118",
            "fax_number": "517-482-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W GREENLAWN AVE",
            "address_2": "#106",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489102898",
            "telephone_number": "517-482-2118",
            "fax_number": "517-482-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRAD",
        "middle_name": "NATHAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "BS015087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4723010",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.