Individual provider Active NPI

Drew Johnson

  • Cardiovascular Disease Physician
  • Philadelphia, PA
National Provider Identifier
1205222163
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD465709 Issued in PA
Practice address
925 Chestnut Street
Mezzanine
Philadelphia, PA 19107
Phone
(215) 955-5050
Fax
(215) 955-2179
NPI assigned
Apr 7, 2015
Last updated
May 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD465709 PA
Student in an Organized Health Care Education/Training Program 390200000X
Cardiovascular Disease Physician 207RC0000X MD465709 PA Primary

Addresses

Primary practice location

925 Chestnut Street
Mezzanine
Philadelphia, PA 19107

Mailing address

925 Chestnut Street
Mezzanine
Philadelphia, PA 19107
Phone (215) 955-5050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20210614002627 PA Practitioner - Internal Medicine 7416276332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

925 Chestnut St
Mezzanine
Philadelphia, PA 19107-4290
Phone (215) 955-5050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD465709PAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians Internal Medicine CurrentSince Aug 1, 2021 Accepting new patients
Jefferson University Physicians Past Accepting new patients
Thomas Jefferson University Hospitals Inc Past Accepting new patients

Locations

1200 York Rd
Abington, PA 19001
Phone (215) 481-2222

225 E City Ave
Ste 10
Bala Cynwyd, PA 19004
Phone (215) 301-9239

100 Medical Campus Dr
Lansdale, PA 19446
Phone (215) 361-4440

1101 Chestnut St
Fl 9
Philadelphia, PA 19107
Phone (215) 955-1682

111 S 11th St
Philadelphia, PA 19107
Phone (215) 955-6161

111 S 11th St
Ste 6210
Philadelphia, PA 19107
Phone (215) 503-5151

833 Chestnut St
Ste 220
Philadelphia, PA 19107
Phone (215) 955-2363

925 Chestnut St
Philadelphia, PA 19107
Phone (215) 955-5050

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1205222163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT STREET",
            "address_2": "MEZZANINE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19107",
            "telephone_number": "215-955-5050",
            "fax_number": "215-955-2179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT STREET",
            "address_2": "MEZZANINE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19107",
            "telephone_number": "215-955-5050",
            "fax_number": "215-955-2179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-07",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD465709",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD465709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.