Individual provider Active NPI

Michael P Johnson, MD

  • Internal Medicine Physician
  • Providence, RI
National Provider Identifier
1366480592
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD09266 Issued in RI
Practice address
148 W River St Ste 22B
Providence, RI 02904-2628
Phone
(401) 521-7100
Fax
(401) 521-7102
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD09266 RI Primary

Addresses

Primary practice location

148 W River St Ste 22B
Providence, RI 02904-2628

Mailing address

148 W River St Ste 22B
Providence, RI 02904-2628
Phone (401) 521-7100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040720001198 RI Practitioner - Internal Medicine 0143200378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
JS Weill Medical College, Cornell University, 1993
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

148 W River St
Providence, RI 02904-2628
Phone (401) 721-7100

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Warwick, RI, CCN 417036
  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007
  • Newport Hospital Hospital, Newport, RI, CCN 410006
  • Women & Infants Hospital of Rhode Island Hospital, Providence, RI, CCN 410010

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michael P. Johnson, MD, Inc Internal Medicine CurrentSince Jun 26, 2018 Accepting new patients

Locations

148 W River St
Ste 22B
Providence, RI 02904
Phone (401) 572-3887

Interoperability endpoints

  • Direct secure messaging: michael.johnson.1@17811.direct.athenahealth.com

Organizations & group practices 1

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 8

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1366480592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 W RIVER ST STE 22B",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042628",
            "telephone_number": "401-521-7100",
            "fax_number": "401-521-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 W RIVER ST STE 22B",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042628",
            "telephone_number": "401-521-7100",
            "fax_number": "401-521-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD09266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.