William Dolph Johnson, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

010949 Issued in NY

Practice address

5968 Route 25a
Wading River, NY 11792-2001

Phone

(631) 929-0304

NPI assigned

May 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Main Street Medical, PC

  • Internal Medicine Physician
  • Bay Shore, NY
  • NPI 1184049835
  NPD (past)
• Roxanne G Carfora, DO, PC

  • Family Medicine Physician
  • Hauppauge, NY
  • NPI 1962830851
  NPD (past)

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376757708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 3RD ST",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117273707",
            "telephone_number": "631-833-4216",
            "fax_number": "718-578-4540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5968 ROUTE 25A",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117922001",
            "telephone_number": "631-929-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "WILLIAM",
        "middle_name": "DOLPH",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alina Jakimiuk-Molik, RN
• William Jantzen, PT
• Art P Jarit, D.D.S.
• Sisley John, RPH
• Lisa Johnson
• Joint Effort Therapeutics Physical Therapy, PC
• Donald Harold Kazenoff, MSSW LCSW
• Geraldine Kazenoff, LCSW
• Meghan Kealey
• Loren Kenney, BSN, RN

• Physician Assistant in Wading River, NY
• Providers in Wading River, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.