Active NPI
Paul Elvin Johnson Jr., MD
- Otolaryngology Physician
- Grants Pass, OR
National Provider Identifier
1235300062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- MD28070
- Practice address
- 1600 NW 6TH St
Grants Pass, OR 97526-1094 - Phone
- (541) 476-7775
- NPI assigned
- Mar 19, 2008
- 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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | MD28070 | OR | Primary |
Addresses
Primary practice location
1600 NW 6TH St
Grants Pass, OR 97526-1094
Mailing address
1600 NW 6TH St
Grants Pass, OR 97526-1094
Phone (541) 476-7775
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100218000415 | WY | Practitioner - Otolaryngology | 8820177579 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- University of Washington School of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ivinson Memorial Hospital
Practice addresses (Care Compare)
3116 Willett Dr
Laramie, WY 82072-5048
Phone (307) 742-6319
Hospital & facility affiliations
- Ivinson Memorial Hospital
- Cheyenne Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.68 of 100
- Quality
- 75.73
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.55
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD28070 | OR | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ivinson Memorial Hospital | Current | Accepting new patients | |
| Ivinson Memorial Hospital | Current | Accepting new patients | |
| Cheyenne Hearing Clinic Inc. | Past | Accepting new patients |
Locations
4136 Laramie St
Unit B
Cheyenne, WY 82001
Phone (307) 637-2800
255 N 30th St
Laramie, WY 82072
Phone (307) 742-2141
3116 Willett Dr
Laramie, WY 82072
Phone (307) 742-6319
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.
-
- Rural Acute Care Hospital
- Laramie, WY
- NPI 1366626269
-
- Rural Acute Care Hospital
- Laramie, WY
- NPI 1336289552
-
- Rural Acute Care Hospital
- Laramie, WY
- NPI 1912181827
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Laramie, WY
- NPI 1952585861
-
- Audiologist
- Cheyenne, WY
- NPI 1285810721
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Cheyenne, WY
- NPI 1285621839
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263168000000",
"number": "1235300062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 NW 6TH ST",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975261094",
"telephone_number": "541-476-7775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 NW 6TH ST",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975261094",
"telephone_number": "541-476-7775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "PAUL",
"middle_name": "ELVIN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-19",
"last_updated": "2010-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "OR",
"license": "MD28070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grants Pass, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; 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.