NPIMap

Individual provider Active NPI

Craig Johnson, PA-C

  • Medical Physician Assistant
  • Berlin, MD
National Provider Identifier
1306021753
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C0001907 Issued in MD
Practice address
10614 Racetrack Road
Berlin, MD 21811
Phone
(410) 208-9761
Fax
(410) 208-9764
NPI assigned
Jan 4, 2008
Last updated
Aug 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0001907 MD Primary

Addresses

Primary practice location

10614 Racetrack Road
Berlin, MD 21811

Mailing address

10026 Old Ocean City Blvd
Building One
Berlin, MD 21811
Phone (410) 641-0430

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080619000668 MD Practitioner - Physician Assistant 6406926260 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tidalhealth Atlantic IncGroup PAC ID 2365437837, 95 clinicians
Tidalhealth Primary Care LLCGroup PAC ID 7911320635, 63 clinicians

Practice addresses (Care Compare)

10026 Old Ocean City Blvd
Suite 1
Berlin, MD 21811-1288
Phone (410) 641-9450

11107 Racetrack Rd
Berlin, MD 21811-3279
Phone (410) 208-9761

400 Eastern Shore Dr
Salisbury, MD 21804-5513
Phone (410) 543-8240

6040 Public Landing Rd
Snow Hill, MD 21863-2453
Phone (410) 629-0041

9714 Healthway Dr
Berlin, MD 21811-1154
Phone (410) 641-3340

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.2 of 100Reported as group
Quality
70.92
Promoting interoperability
98
Improvement activities
40
Cost
71.41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tidalhealth Primary Care, LLC CurrentSince Mar 1, 2026 Accepting new patients
Tidalhealth Specialty Care, LLC CurrentSince Mar 1, 2026 Accepting new patients
Tidalhealth Atlantic, Inc. CurrentSince Apr 1, 2008 Accepting new patients
Atlantic General Hospital Corporation Past Accepting new patients
Atlantic Immedicare LLC Past Accepting new patients

Locations

10026 Old Ocean City Blvd
Ste 1
Berlin, MD 21811

9714 Healthway Dr
Berlin, MD 21811
Phone (410) 641-2600

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

400 Eastern Shore Dr
Salisbury, MD 21804
Phone (410) 543-2255

6040 Public Landing Rd
Snow Hill, MD 21863
Phone (410) 629-0041

Interoperability endpoints

  • Direct secure messaging: craigjohnson@agh.allscriptsdirect.net

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

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1306021753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10026 OLD OCEAN CITY BLVD",
            "address_2": "BUILDING ONE",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "21811",
            "telephone_number": "410-641-0430",
            "fax_number": "410-641-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10614 RACETRACK ROAD",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "21811",
            "telephone_number": "410-208-9761",
            "fax_number": "410-208-9764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CRAIG",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-04",
        "last_updated": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0001907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, MD

Sources for this page

Verify at the official NPI Registry.