NPIMap

Individual provider Active NPI

Thomas Edward Johnson, M.D.

  • Diagnostic Radiology Physician
  • San Diego, CA
National Provider Identifier
1245624436
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A169018 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
NPI assigned
Mar 25, 2015
Last updated
Jul 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A169018 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, SD, MN3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200729003660 CA Practitioner - Diagnostic Radiology 1355643156 Reassigns benefits to 2 organizations
I20210706003022 SD Practitioner - Diagnostic Radiology 1355643156 Reassigns benefits to 6 organizations
I20211101000562 MN Practitioner - Diagnostic Radiology 1355643156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of North Dakota School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health ServicesGroup PAC ID 6103729066, 151 clinicians
Avera McKennanGroup PAC ID 0345157103, 957 clinicians
Avera MarshallGroup PAC ID 5799695227, 102 clinicians
Avera Queen of PeaceGroup PAC ID 9335050806, 122 clinicians
Urology Specialists CharteredGroup PAC ID 9234031329, 47 clinicians
Madison Community HospitalGroup PAC ID 3779579743, 46 clinicians

Practice addresses (Care Compare)

1000 W 4TH St
Suite 8
Yankton, SD 57078-3700

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

201 W 69TH St
Sioux Falls, SD 57108-2403
Phone (605) 336-0635

323 SW 10TH St
Madison, SD 57042-3200
Phone (605) 256-6551

501 Summit St
Yankton, SD 57078-3855
Phone (605) 668-8795

525 N Foster St
Mitchell, SD 57301-2966
Phone (605) 995-2234

901 E Virgil Ave
Milbank, SD 57252-2124
Phone (605) 432-4538

910 E 20TH St
Sioux Falls, SD 57105-1012
Phone (605) 334-6730

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A169018CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera Queen of Peace Current Accepting new patients
Sacred Heart Health Services CurrentSince Nov 30, 2023 Accepting new patients
Regents of the University of California Ucsd Department of Radiology Diagnostic Radiology CurrentSince Jun 27, 2020 Accepting new patients
Sacred Heart Health Services CurrentSince Nov 30, 2023 Accepting new patients
Avera Queen of Peace CurrentSince Sep 1, 2021 Accepting new patients
Avera McKennan CurrentSince Aug 1, 2021 Accepting new patients
Avera Marshall CurrentSince Jan 16, 2024 Accepting new patients
Avera Marshall CurrentSince Sep 1, 2021 Accepting new patients
Avera Queen of Peace CurrentSince Sep 1, 2021 Accepting new patients
Regents of the University of California Diagnostic Radiology CurrentSince Jun 27, 2020 Accepting new patients
Avera Marshall Current Accepting new patients
Madison Community Hospital CurrentSince Aug 1, 2021 Accepting new patients
Avera McKennan Current Accepting new patients
Sacred Heart Health Services Current Accepting new patients
Urology Specialists Chartered CurrentSince Oct 1, 2022 Accepting new patients
Madison Community Hospital CurrentSince Aug 1, 2021 Accepting new patients
Avera Marshall CurrentSince Sep 1, 2021 Accepting new patients

Locations

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5720

8929 University Center Ln
Ste 101
San Diego, CA 92122
Phone (858) 457-4227

300 S Bruce St
Marshall, MN 56258
Phone (507) 532-9631

323 SW 10th St
Madison, SD 57042
Phone (605) 256-6551

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

1325 S Cliff Ave
Sioux Falls, SD 57105
Phone (605) 322-5000

201 W 69th St
Sioux Falls, SD 57108
Phone (605) 336-0635

910 E 20th St
Sioux Falls, SD 57105
Phone (602) 338-7098

501 Summit St
Yankton, SD 57078
Phone (605) 655-1201

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: thomas.ojohnson.p1@direct.urologyspecialists.nextgenshare.com

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1245624436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "THOMAS",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-25",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A169018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.