NPIMap

Individual provider Active NPI

Mark William Johnson, MD

  • Internal Medicine Physician
  • Cambridge, MA
National Provider Identifier
1316436793
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
276370 Issued in MA
Practice address
330 Mount Auburn St
Cambridge, MA 02138
Phone
(617) 492-3500
NPI assigned
May 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 33075 NH
Internal Medicine Physician 207R00000X 276370 MA Primary

Addresses

Primary practice location

330 Mount Auburn St
Cambridge, MA 02138

Mailing address

330 Mount Auburn St
Cambridge, MA 02138-5597
Phone (617) 492-3500

Other practice location 1

1 Medical Center Dr
Lebanon, NH 03756-0001
Phone (603) 650-5000

Other practice location 2

273 County Rd
New London, NH 03257-5736
Phone (603) 526-2911

Other practice location 3

10 Alice Peck Day Dr
Lebanon, NH 03766-2900
Phone (603) 448-3121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, ND, VT3 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
I20240708002795 NH Practitioner - Diagnostic Radiology 4789931460 Reassigns benefits to 2 organizations
I20240712001497 ND Practitioner - Diagnostic Radiology 4789931460 Reassigns benefits to 1 organization
I20240717000906 VT Practitioner - Diagnostic Radiology 4789931460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Minnesota Medical School, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

25 Ridgewood Rd
Springfield, VT 05156-3050
Phone (802) 885-2151

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
83.48 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.91

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Alexius Medical Center CurrentSince Jul 1, 2024 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Jul 8, 2024 Accepting new patients
St. Alexius Medical Center CurrentSince Jul 1, 2024 Accepting new patients
Mary Hitchcock Memorial Hospital Internal Medicine Current Accepting new patients
Mary Hitchcock Memorial Hospital Internal Medicine CurrentSince Jul 8, 2024 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jul 8, 2024 Accepting new patients
Dartmouth-Hitchcock Clinic Internal Medicine CurrentSince Jul 8, 2024 Accepting new patients
Brattleboro Memorial Hospital Internal Medicine PastSince Aug 1, 2016 Accepting new patients

Locations

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

10 Alice Peck Day Dr
Lebanon, NH 03766
Phone (603) 448-7440

273 County Rd
New London, NH 03257
Phone (603) 526-5215

53 Fairview St
Brattleboro, VT 05301
Phone (802) 251-8455

25 Ridgewood Rd
Springfield, VT 05156
Phone (780) 281-9593

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/d9dc001d-1bc5-42f9-bd4d-eb79208fd32a/
  • Direct secure messaging: mjohnson362542@direct.dartmouth-hitchcock.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 12

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": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1316436793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 MOUNT AUBURN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385597",
            "telephone_number": "617-492-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 MOUNT AUBURN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "02138",
            "telephone_number": "617-492-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037560001",
            "country_code": "US",
            "telephone_number": "603-650-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "273 County Rd",
            "address_purpose": "LOCATION",
            "city": "New London",
            "state": "NH",
            "postal_code": "032575736",
            "country_code": "US",
            "telephone_number": "603-526-2911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Alice Peck Day Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037662900",
            "country_code": "US",
            "telephone_number": "603-448-3121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-01",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NH",
            "license": "33075",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "276370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.