Individual provider Active NPI

Kendall Rae Johnson, MD

  • Internal Medicine Physician
  • Delray Beach, FL
National Provider Identifier
1205331352
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME151229 Issued in FL
Practice address
5352 Linton Blvd
Delray Beach, FL 33484-6514
Phone
(561) 498-4440
NPI assigned
Mar 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X FL
Internal Medicine Physician 207R00000X ME151229 FL Primary

Addresses

Primary practice location

5352 Linton Blvd
Delray Beach, FL 33484-6514

Mailing address

5352 Linton Blvd
Delray Beach, FL 33484-6514
Phone (561) 498-4440

Other practice location 1

2623 S Seacrest Blvd
Boynton Beach, FL 33435-7501
Phone (561) 735-6553

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210722003251 FL Practitioner - Internal Medicine 9436405412 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medicine Services, LLCGroup PAC ID 7810129640, 263 clinicians

Practice addresses (Care Compare)

5352 Linton Blvd
Delray Beach, FL 33484-6514
Phone (561) 498-4440

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME151229FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Florida Hospitalists Inc CurrentSince Aug 1, 2021 Accepting new patients
Florida Hospital Medicine Services, LLC. CurrentSince Jan 1, 2023 Accepting new patients

Locations

9655 Boynton Beach Blvd
Boynton Beach, FL 33472
Phone (561) 336-7000

5352 Linton Blvd
Delray Beach, FL 33484
Phone (561) 495-3166

Organizations & group practices 2

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 4

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": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1205331352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5352 LINTON BLVD",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846514",
            "telephone_number": "561-498-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5352 LINTON BLVD",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846514",
            "telephone_number": "561-498-4440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2623 S Seacrest Blvd",
            "address_purpose": "LOCATION",
            "city": "Boynton Beach",
            "state": "FL",
            "postal_code": "334357501",
            "country_code": "US",
            "telephone_number": "561-735-6553",
            "fax_number": "561-735-7739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KENDALL",
        "middle_name": "RAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME151229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

Verify at the official NPI Registry.