Andre Lyndon B Johnson, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DR.73490 Issued in CO

Practice address

9137 Ridgeline Blvd Ste 100
Highlands Ranch, CO 80129-2397

Phone

(303) 649-3140

Fax

(303) 649-3154

NPI assigned

Apr 20, 2021

Last updated

Feb 13, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Family Practice

Education

Alabama College of Osteopathic Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Portercare Adventist Health SystemGroup PAC ID 0941110886, 770 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• AdventHealth Porter Hospital, Denver, CO, CCN 060064

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ajohnson4133078@adventhealth.direct-ci.com

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.

• Portercare Adventist Health System

  dba Affiliated Ear, Nose & Throat Physicians

  • Otolaryngology Physician
  • Greenwood Village, CO
  • NPI 1760761928
  Medicare reassignment Care Compare group NPD
• Portercare Adventist Health System

  dba AdventHealth Medical Group OB/GYN at Littleton

  • Obstetrics & Gynecology Physician
  • Littleton, CO
  • NPI 1619390200
  NPD
• Portercare Adventist Health System

  dba AdventHealth Medical Group Urology at Lakewood

  • Urology Physician
  • Lakewood, CO
  • NPI 1942165626
  NPD

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

• Portercare Adventist Health System

  dba Adventhealth Porter

  • General Acute Care Hospital
  • Denver, CO
  • NPI 1801800594
  Care Compare affiliation

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1245811280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9137 RIDGELINE BLVD STE 100",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801292397",
            "telephone_number": "303-649-3140",
            "fax_number": "303-649-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9137 RIDGELINE BLVD STE 100",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801292397",
            "telephone_number": "303-649-3140",
            "fax_number": "303-649-3154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14300 Orchard Pkwy Fl 1",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "CO",
            "postal_code": "800239206",
            "country_code": "US",
            "telephone_number": "303-430-5560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANDRE",
        "middle_name": "LYNDON B",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-20",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "TL0008743",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.73490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney C Jensen, M.S. CCC-SLP
• Jamon Jensen, DDS MSD
• John G McDaniel, OD LLC
• Premod James John, M.D.
• Janice Elizabeth Johnsen, PA
• Emmanuel Andre Johnson, BT
• Jasmine Alexandria Johnson, DPT
• Katherine Kirkland Johnson, NP
• Lauren Diane Johnson, MS
• Mary Lou B Johnson, M.S.

• Family Medicine Physician in Highlands Ranch, CO
• Providers in Highlands Ranch, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; 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.

Verify at the official NPI Registry.