NPIMap

Organization Active NPI

Brandon B Johnson MD PC

  • Ophthalmology Physician
  • New York, NY
National Provider Identifier
1356963755
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
BRANDON B JOHNSON MD PC
Practice address
161 E 32ND St
New York, NY 10016-6002
Phone
(212) 979-2020
Fax
(267) 421-4838
NPI assigned
May 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Authorized official

Name
Brandon B Johnson, MDNPI 1386806693
Title
Practice Owner
Phone
(917) 284-6999

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X Primary
Retina Specialist (Ophthalmology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207WX0107X

Addresses

Primary practice location

161 E 32ND St
New York, NY 10016-6002

Mailing address

161 E 32ND St
New York, NY 10016-6002
Phone (917) 284-6999

Other practice location 1

13625 Maple Ave Ste 202
Flushing, NY 11355-3891
Phone (718) 358-5900

Other names 1

  • New York Retina Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200817001182 NY Part B Supplier - Clinic/Group Practice 1850717265 Receives reassigned benefits from 1 practitioner
Practice locations: Elmhurst, NY; Flushing, NY; Jackson Heights, NY; New York, NY

National Provider Directory

National Provider Directory

Locations

457 E 149th St
Bronx, NY 10455
Phone (718) 292-2020

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1588896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626912000000",
    "number": "1356963755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 E 32ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166002",
            "telephone_number": "917-284-6999",
            "fax_number": "917-551-5795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 E 32ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166002",
            "telephone_number": "212-979-2020",
            "fax_number": "267-421-4838"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13625 Maple Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113553891",
            "country_code": "US",
            "telephone_number": "718-358-5900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRANDON B JOHNSON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-08",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "917-284-6999",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New York Retina Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.