Jonathon Ryan Johnston, DO
Individual provider Active NPI Emergency Medicine Physician · Tulsa, OK
NPI 1356832844 · NPPES record last updated Jul 20, 2022
Key facts
- NPI
- 1356832844
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 7587 (OK)
- Practice address
- 1717 S Utica Ave Ste a
Tulsa, OK 74104-5346 - Phone
- (918) 358-6064
- Fax
- (918) 403-0383
- NPI assigned
- May 21, 2018
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 17
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cherokee Nation
Practice addresses (Care Compare)
100 S Bliss Ave
Tahlequah, OK 74464-2512
Phone (918) 458-3100
Hospital & facility affiliations
- Cherokee Nation W W Hastings Indian Hospital
- Northeastern Health System
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.51 of 100
- Quality
- 84.87
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in MO, OK, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210115001067 | MO | Practitioner - Emergency Medicine | 1355754102 | Reassigns benefits to 3 organizations |
| I20220812001484 | OK | Practitioner - Emergency Medicine | 1355754102 | Reassigns benefits to 2 organizations |
| I20241211000059 | TX | Practitioner - Emergency Medicine | 1355754102 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7587 | OK | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Freeman Neosho Hospital | Current |
Accepting new patients | |
| Freeman-Oak Hill Health System | Current |
Accepting new patients | |
| Freeman Neosho Hospital | Current |
Accepting new patients | |
| Cherokee Nation | Current |
Accepting new patients | |
| St. John Physicians, Inc | Current |
Accepting new patients | |
| Emergency Medicine Physicians of Tulsa County, LLC | Emergency Medicine | Current |
Accepting new patients |
| Cherokee Nation | Current |
Accepting new patients | |
| St. John Physicians, Inc. | Emergency Medicine | Current | Accepting new patients |
| Freeman-Oak Hill Health System | Current |
Accepting new patients | |
| Freeman Neosho Hospital | Current |
Accepting new patients | |
| Cherokee Nation | Past | Accepting new patients | |
| Owasso Medical Facility, Inc | Past | Accepting new patients | |
| St John Sapulpa, Inc. | Past | Accepting new patients | |
| St. John Broken Arrow, Inc | Past | Accepting new patients |
Locations
1102 W 32nd St
Joplin, MO 64804
Phone (417) 347-1078
1130 E 32nd St
Joplin, MO 64804
Phone (417) 347-2273
1130 E 32nd St
Ste F
Joplin, MO 64804
Phone (417) 347-7400
113 W Hickory St
Neosho, MO 64850
Phone (417) 347-1078
336 S Jefferson St
Neosho, MO 64850
Phone (417) 451-4200
1636 S Madison St
Webb City, MO 64870
Phone (417) 347-2273
3500 E Frank Phillips Blvd
Bartlesville, OK 74006
Phone (918) 331-1555
1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000
859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271
1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192
12451 E 100th St N
Owasso, OK 74055
Phone (918) 274-5000
900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500
1004 E Bryan Ave
Sapulpa, OK 74066
Phone (918) 224-4280
100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100
1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660
1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585
1725 E 19th St
Tulsa, OK 74104
Phone (918) 301-2505
1717 S Utica Ave
Ste A
Tulsa, OK 74104
Phone (918) 748-1300
10501 E 91st St
Tulsa, OK 74133
Phone (918) 307-6000
1725 E 19th St
Ste 500
Tulsa, OK 74104
Phone (918) 403-7089
Dept 2269
Tulsa, OK 74182
27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 7587 | OK | Yes |
Addresses
Primary practice location
1717 S Utica Ave Ste a
Tulsa, OK 74104-5346
Mailing address
1717 S Utica Ave Ste a
Tulsa, OK 74104-5346
Phone (918) 358-6064
Other practice location 1
1031 McIntosh Cir
Joplin, MO 64804-3643
Phone (417) 347-5665
Other practice location 2
1102 W 32nd St
Joplin, MO 64804-3503
Phone (417) 347-1111
Other providers in Tulsa, OK
- Wade Russell Johnson
- Wakie I Johnson
- Wyatt McCuiston Johnson
- Amanda Renae Johnston
- Dylan Johnston
- Kayla Johnston
- Lisa Diane Johnston
- Mattie Grace Johnston
- Nathan Erik-James Johnston
- Susan Johnston
All providers in Tulsa, OK · Emergency Medicine Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.