Individual provider Active NPI

Andrew Mark Johnson, DPT

  • Physical Therapist
  • Saint Clair Shores, MI
National Provider Identifier
1285106799
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501019004 Issued in MI
Practice address
24715 Little Mack Ave Ste 100
Saint Clair Shores, MI 48080-3207
Phone
(586) 779-2585
NPI assigned
Dec 21, 2018
Last updated
Sep 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501019004 MI Primary

Addresses

Primary practice location

24715 Little Mack Ave Ste 100
Saint Clair Shores, MI 48080-3207

Mailing address

24715 Little Mack Ave Ste 100
Saint Clair Shores, MI 48080-3207
Phone (586) 779-7970

Other practice location 1

30078 Schoenherr Rd Ste 200
Warren, MI 48088-3178
Phone (586) 806-6284

Other practice location 2

937 N Opdyke Rd
Auburn Hills, MI 48326-2641
Phone (248) 724-0864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190111000632 MI Practitioner - Physical Therapist in Private Practice 6507102555 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Wayne State University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

24715 Little Mack Ave
Suite 100
Saint Clair Shores, MI 48080-3207
Phone (586) 779-7970

Merit-based Incentive Payment System (MIPS)

Final score
84.24 of 100Reported as group
Quality
48.29
Promoting interoperability
99
Improvement activities
40
Cost
100

Merit-based Incentive Payment System (MIPS)

Final score
88.14 of 100Reported as group
Quality
80.64
Promoting interoperability
100
Improvement activities
40
Cost
79.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Orthopedists of Detroit PC Physical Therapist CurrentSince Sep 3, 2024 Accepting new patients
Aks of Romeo LLC Physical Therapist CurrentSince Dec 19, 2018 Accepting new patients
John E Samani MD PC CurrentSince Mar 1, 2021 Accepting new patients
Associated Orthopedists of Detroit, PC Physical Therapist CurrentSince Sep 3, 2024 Accepting new patients

Locations

937 N Opdyke Rd
Auburn Hills, MI 48326
Phone (248) 373-7600

204 W Buttles St
Ste A
Midland, MI 48640

1773 Star Batt Dr
Rochester Hills, MI 48309
Phone (248) 650-4720

67962 Van Dyke Rd
Romeo, MI 48065
Phone (586) 336-4022

50505 Schoenherr Rd
Ste 120
Shelby Township, MI 48315
Phone (586) 412-1411

24715 Little Mack Ave
Ste 100
St Clr Shores, MI 48080
Phone (586) 779-2585

Interoperability endpoints

  • Direct secure messaging: andrew.johnson.1@24034.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/24034/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1545350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1285106799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24715 LITTLE MACK AVE STE 100",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480803207",
            "telephone_number": "586-779-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24715 LITTLE MACK AVE STE 100",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480803207",
            "telephone_number": "586-779-2585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30078 Schoenherr Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480883178",
            "country_code": "US",
            "telephone_number": "586-806-6284",
            "fax_number": "586-806-6274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "937 N Opdyke Rd",
            "address_purpose": "LOCATION",
            "city": "Auburn Hills",
            "state": "MI",
            "postal_code": "483262641",
            "country_code": "US",
            "telephone_number": "248-724-0864",
            "fax_number": "248-373-7443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANDREW",
        "middle_name": "MARK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-21",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501019004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.