Individual provider Active NPI

Benjamin J Johnson, M.D.

  • Urology Physician
  • Livonia, MI
National Provider Identifier
1366703605
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
4301106414 Issued in MI
Practice address
15138 Levan Rd
Livonia, MI 48154-5027
Phone
(734) 779-2133
NPI assigned
Jun 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 4301106414 MI Primary

Addresses

Primary practice location

15138 Levan Rd
Livonia, MI 48154-5027

Mailing address

31157 Woodward Ave
Royal Oak, MI 48073-0996
Phone (248) 336-0123

Other practice location 1

11100 Euclid Ave
University Hospitals Case Medical Center
Cleveland, OH 44106-1716
Phone (519) 972-1480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160928001898 MI Practitioner - Urology 2466749825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

22250 Providence Dr
Suite 210
Southfield, MI 48075-6210
Phone (248) 569-4897

27900 Grand River Ave
Suite 220
Farmington Hills, MI 48336-5965
Phone (248) 477-0552

32255 Northwestern Hwy
Farmington Hills, MI 48334-1575

32255 Northwestern Hwy 135
Mi Healthcare Prof. PC
Farmington Hills, MI 48334-1575
Phone (947) 228-5500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301106414MIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC CurrentSince Sep 1, 2016 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Sep 1, 2016 Accepting new patients

Locations

32255 Northwestern Hwy
Ste 105
Farmington Hills, MI 48334
Phone (248) 406-1090

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

26850 Providence Pkwy
Ste 130
Novi, MI 48374
Phone (248) 569-4897

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

31157 Woodward Ave
Royal Oak, MI 48073
Phone (248) 288-2250

22250 Providence Dr
Ste 210
Southfield, MI 48075
Phone (248) 483-8488

Interoperability endpoints

  • Direct secure messaging: bjohnson1133476@direct.hfhs.org
  • Direct secure messaging: benjamin.johnson.1@18740.direct.athenahealth.com

Organizations & group practices 2

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 2

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": "1338768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1366703605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31157 WOODWARD AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480730996",
            "telephone_number": "248-336-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15138 LEVAN RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481545027",
            "telephone_number": "734-779-2133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11100 Euclid Ave",
            "address_2": "University Hospitals Case Medical Center",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441061716",
            "country_code": "US",
            "telephone_number": "519-972-1480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BENJAMIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301106414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.