Individual provider Active NPI

Millisaun Johnson, M.D.

  • Hospitalist Physician
  • Jersey City, NJ
National Provider Identifier
1275574766
Registry record updated Aug 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD426038 Issued in PA
Practice address
408 Bergen Ave
Jersey City
Jersey City, NJ 07304
Phone
(201) 451-5137
NPI assigned
Jun 8, 2006
Last updated
Aug 13, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD426038 PA
Hospitalist Physician 208M00000X MD426038 PA Primary

Addresses

Primary practice location

408 Bergen Ave
Jersey City
Jersey City, NJ 07304

Mailing address

408 Bergen Ave
Jersey City
Jersey City, NJ 07304-2202
Phone (201) 451-5137

Other practice location 1

1205 Langhorne Newtown Rd Ste 403
Langhorne, PA 19047-1223
Phone (215) 710-4460

Other identifiers 8

IdentifierTypeStateIssuer
101656810-01OtherPAAMERICHOICE-TC
30034506OtherPAKEYSTONE MERCY
1016568100002MedicaidPA
1872726OtherPAHIGHMARK BLUE SHIELD
1016568100001MedicaidPA
2732298000OtherPAKEYSTONE IBC
34936OtherPAHEALTH PARTNERS
34937OtherPAHEALTH PARTNERS - BUCKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20060720000157 PA Practitioner - Internal Medicine 0345253282 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rutgers New Jersey Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1225 Warm Springs Ave
Huntingdon, PA 16652-2350
Phone (814) 643-2290

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health Mid-Atlantic Medical Group CurrentSince Dec 1, 2015 Accepting new patients
Geisinger Clinic Internal Medicine CurrentSince Nov 1, 2012 Accepting new patients
Upmc Altoona CurrentSince May 21, 2018 Accepting new patients
St. Luke's Physician Group, Inc CurrentSince Mar 14, 2017 Accepting new patients
Geisinger Clinic Current Accepting new patients
Upmc Altoona CurrentSince May 21, 2018 Accepting new patients
Geisinger Clinic CurrentSince Nov 1, 2012 Accepting new patients
Apogee Medical Group of Pennsylvania PC Internal Medicine CurrentSince Jul 5, 2015 Accepting new patients
Trinity Health Mid-Atlantic Medical Group CurrentSince Dec 1, 2015 Accepting new patients
Apogee Medical Group of Pennsylvania PC Internal Medicine CurrentSince Jul 5, 2015 Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
St Luke's Physician Group Inc CurrentSince Mar 14, 2017 Accepting new patients
J C Blair Medical Services Inc Internal Medicine CurrentSince Apr 20, 2019 Accepting new patients
Trinity Health Mid-Atlantic Medical Group Current Accepting new patients
J. C. Blair Memorial Hospital Past Accepting new patients
Aria Health Physician Services Internal Medicine Past Accepting new patients

Locations

15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601

620 Howard Ave
Altoona, PA 16601
Phone (814) 889-2011

100 N Academy Ave
Danville, PA 17822

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

100 Hospital Ave
Ofc
Dubois, PA 15801

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

1225 Warm Springs Ave
Huntingdon, PA 16652
Phone (814) 643-8206

1227 Warm Springs Ave
Huntingdon, PA 16652
Phone (814) 643-8478

7651 Lake Raystown Shopping Ctr
Huntingdon, PA 16652
Phone (814) 643-8485

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

1205 Langhorne Newtown Rd
Ste 403
Langhorne, PA 19047
Phone (215) 710-4460

211 N 12th St
Lehighton, PA 18235
Phone (610) 377-1300

1201 Langhorne Newtown Rd
Penndel, PA 19047
Phone (215) 710-2100

200 Scenery Dr
State College, PA 16801
Phone (814) 231-4560

239 Colonnade Blvd
State College, PA 16803
Phone (582) 220-2192

187 Hospital Dr
Tyrone, PA 16686
Phone (814) 342-2333

1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300

Organizations & group practices 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1275574766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 BERGEN AVE",
            "address_2": "JERSEY CITY",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073042202",
            "telephone_number": "201-451-5137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 BERGEN AVE",
            "address_2": "JERSEY CITY",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07304",
            "telephone_number": "201-451-5137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1205 Langhorne Newtown Rd Ste 403",
            "address_purpose": "LOCATION",
            "city": "Langhorne",
            "state": "PA",
            "postal_code": "190471223",
            "country_code": "US",
            "telephone_number": "215-710-4460",
            "fax_number": "215-710-4465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MILLISAUN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD426038",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD426038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE-TC",
            "identifier": "101656810-01",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "30034506",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016568100002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1872726",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016568100001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE IBC",
            "identifier": "2732298000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "34936",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS - BUCKS",
            "identifier": "34937",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.