Active NPI
Dominique Latrice Johnson, DO
- Family Medicine Physician
- Chicago, IL
National Provider Identifier
1386218147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036-171797
- Practice address
- 901 E 95TH St
Chicago, IL 60619-7861 - Phone
- (312) 878-9240
- NPI assigned
- May 17, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5151015221 | MI | |
| Family Medicine Physician | 207Q00000X | 036-171797 | IL | Primary |
Addresses
Primary practice location
901 E 95TH St
Chicago, IL 60619-7861
Mailing address
29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | djohnson385344@direct.myadvocateaurora.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Michigan State University College of Osteopathic Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
901 E 95TH St
Chicago, IL 60619-7826
Phone (312) 878-9240
Hospital & facility affiliations
- Advocate Home Health Care Serv
- Advocate Trinity Hospital
- Advocate Christ Hospital & Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.02 of 100
- Quality
- 85.37
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Advocate Health & Hospitals Corporation | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients |
Locations
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
901 E 95th St
Chicago, IL 60619
Phone (312) 878-9240
29373 Network Pl
Chicago, IL 60673
Interoperability endpoints
- djohnson409332@direct.myadvocateaurora.org
- djohnson691146@direct.hfhs.org
- djohnson385344@direct.myadvocateaurora.org
- dominique.johnson.1@16555.direct.athenahealth.com
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
-
- Medical Specialty Clinic/Center
- Oak Lawn, IL
- NPI 1912936014
-
- Children's Hospital
- Oak Lawn, IL
- NPI 1508315516
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hazel Crest, IL
- NPI 1467560128
-
- Children's Hospital
- Oak Lawn, IL
- NPI 1508315516
-
- General Acute Care Hospital
- Oak Lawn, IL
- NPI 1548375082
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1558479212
-
- Home Health Agency
- Oak Brook, IL
- NPI 1598732075
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726099200000",
"number": "1386218147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29373 NETWORK PL",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606731293",
"telephone_number": "847-390-5900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 E 95TH ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606197861",
"telephone_number": "312-878-9240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "DOMINIQUE",
"middle_name": "LATRICE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-17",
"last_updated": "2024-09-12",
"certification_date": "2024-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "5151015221",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036-171797",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "djohnson385344@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "901 E 95th St",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "606197861",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.