Active NPI
David Marshall Johnson, PA-C
- Physician Assistant
- Dearborn, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601003988
- Practice address
- 18101 Oakwood Blvd
Dearborn, MI 48124-4089 - Phone
- (313) 982-5440
- NPI assigned
- Nov 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601003988 | MI | Primary |
Addresses
Primary practice location
18101 Oakwood Blvd
Dearborn, MI 48124-4089
Mailing address
26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1848
Other practice location 1
718 N Macomb St
Monroe, MI 48162-7815
Phone (734) 240-8404
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | djohnson117283@direct.beaumont.edu |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
18101 Oakwood Blvd
Dearborn, MI 48124-4089
44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-1187
44201 Dequindre Rd Ec
Beaumont Emergency Services TR
Troy, MI 48085-1117
Phone (248) 964-5111
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.64 of 100
- Quality
- 85.06
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.9
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601003988 | MI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oakwood Group IX, LLC | Past | Accepting new patients | |
| Monroe Emergency Physicians | Past | Accepting new patients |
Interoperability endpoints
- djohnson1240014@epic00.shdirect.org
Organizations & group practices 4
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.
-
- Hospitalist Physician
- Royal Oak, MI
- NPI 1427567858
-
- Emergency Medicine Physician
- Dearborn, MI
- NPI 1952740656
-
- Emergency Medicine Physician
- Monroe, MI
- NPI 1639103393
-
- Internal Medicine Physician
- Dearborn, MI
- NPI 1720050917
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Dearborn, MI
- NPI 1740230119
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1235208364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26901 BEAUMONT BLVD STE 3D",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333849",
"telephone_number": "947-522-1848",
"fax_number": "947-522-0307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18101 OAKWOOD BLVD",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481244089",
"telephone_number": "313-982-5440"
}
],
"practiceLocations": [
{
"address_1": "718 N Macomb St",
"address_purpose": "LOCATION",
"city": "Monroe",
"state": "MI",
"postal_code": "481627815",
"country_code": "US",
"telephone_number": "734-240-8404",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "DAVID",
"middle_name": "MARSHALL",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-06",
"last_updated": "2022-07-21",
"certification_date": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601003988",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "djohnson117283@direct.beaumont.edu",
"affiliation": "N",
"address_1": "18101 Oakwood Blvd",
"city": "Dearborn",
"state": "MI",
"country_code": "US",
"postal_code": "481244089",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.