Zachary Philip Johannesson, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

328336 Issued in NY

Practice address

50 Leroy St
Potsdam, NY 13676-1786

Phone

(315) 265-3300

NPI assigned

Apr 3, 2021

Last updated

Aug 28, 2024By the provider in NPPES

Sex

Male

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 NY

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

Emergency Medicine

Education

Ohio State University College of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Canton-Potsdam HospitalGroup PAC ID 6204827280, 243 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Canton-Potsdam Hospital Hospital, Potsdam, NY, CCN 330197
• Gouverneur Hospital Hospital, Gouverneur, NY, CCN 331315

Merit-based Incentive Payment System (MIPS)

Final score

98.56 of 100Reported as apm

Quality

87.76

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

98.56 of 100Reported as apm

Quality

87.76

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

98.56 of 100Reported as apm

Quality

87.76

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Canton-Potsdam Hospital

  • General Acute Care Hospital
  • Potsdam, NY
  • NPI 1568548782
  Medicare reassignment Care Compare group NPD
• Gouverneur Hospital

  dba Gouverneur Hospital, Inc. Medical Professional Group

  • Critical Access Hospital
  • Gouverneur, NY
  • NPI 1295156412
  Medicare reassignment NPD
• Gouverneur Hospital

  • Critical Access Hospital
  • Gouverneur, NY
  • NPI 1629409925
  Medicare reassignment NPD
• Massena Hospital Inc

  • Critical Access Hospital
  • Massena, NY
  • NPI 1972604460
  Medicare reassignment NPD
• Canton-Potsdam Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Potsdam, NY
  • NPI 1114104445
  NPD
• Massena Hospital, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Massena, NY
  • NPI 1619756640
  NPD

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

• Canton-Potsdam Hospital

  • General Acute Care Hospital
  • Potsdam, NY
  • NPI 1568548782
  Care Compare affiliation
• Gouverneur Hospital

  • Critical Access Hospital
  • Gouverneur, NY
  • NPI 1629409925
  Care Compare affiliation

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

{
    "created_epoch": "1617408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1184203663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LEROY ST",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 LEROY ST",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761786",
            "telephone_number": "315-265-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "376 W 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101280",
            "country_code": "US",
            "telephone_number": "614-293-3570",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "77 W Barney St",
            "address_purpose": "LOCATION",
            "city": "Gouverneur",
            "state": "NY",
            "postal_code": "136421040",
            "country_code": "US",
            "telephone_number": "315-287-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Massena",
            "state": "NY",
            "postal_code": "136621056",
            "country_code": "US",
            "telephone_number": "315-769-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHANNESSON",
        "first_name": "ZACHARY",
        "middle_name": "PHILIP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-03",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "328336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eboni Christina January, M.D.
• Amber Jarrett, R.N.
• Matthew Clark Jenison, ACNP
• Bernadette Lori Jenkins, OPTICIAN
• Stacie Jessmer, PTA
• Melissa Jo Johnson, PHARMD
• Amy Jones, LPN
• Heather Genevieve Jones, M.D.
• Michael L Joyce, PA
• Terri E Joyce, PA

• Emergency Medicine Physician in Potsdam, NY
• Providers in Potsdam, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.