Individual provider Active NPI

Andrew Kelly Johnson, M.D.

  • Neurological Surgery Physician
  • Chicago, IL
National Provider Identifier
1386890150
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
036.135367 Issued in IL
Practice address
5115 N Francisco Ave
Chicago, IL 60625-3611
Phone
(773) 878-8200
Fax
(773) 293-8804
NPI assigned
Aug 13, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 036.135367 IL Primary

Addresses

Primary practice location

5115 N Francisco Ave
Chicago, IL 60625-3611

Mailing address

5115 N Francisco Ave
Chicago, IL 60625-3611
Phone (773) 878-8200

Other practice location 1

2740 W Foster Ave
Ste 310
Chicago, IL 60625-3500
Phone (773) 878-8200 ext. 6824

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ajohnson275267@direct.northshore.org

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170419000865 IL Practitioner - Neurosurgery 1254651979 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Columbia University College of Physicians and Surgeons, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

2739 W Foster Ave
Chicago, IL 60625-3661
Phone (773) 878-8200

3122 N Ashland Ave
Chicago, IL 60657-3014
Phone (773) 687-0999

5115 N Francisco
Garden Pavillon
Chicago, IL 60625-3611
Phone (773) 989-5571

5115 N Francisco Ave
Chicago, IL 60625-3611
Phone (847) 570-1440

5140 N California
Suite G600
Chicago, IL 60625-3645
Phone (773) 989-3803

5140 N California Ave
Chicago, IL 60625-3645

5145 N California
Hosps Suite 331
Chicago, IL 60625-3661
Phone (847) 570-2280

5145 N California Ave
Chicago, IL 60625-3661
Phone (773) 878-8200

Hospital & facility affiliations

  • Swedish Hospital Hospital, Chicago, IL, CCN 140114
  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion201
Laminectomy or laminotomy (partial removal of spine bones)42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.135367ILMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Covenant Management Services, Inc. Neurological Surgery CurrentSince Jun 1, 2017 Accepting new patients
Endeavor Health Medical Group CurrentSince Feb 17, 2020 Accepting new patients
Endeavor Health Medical Group Neurological Surgery Current Accepting new patients
Swedish Covenant Management Services, Inc CurrentSince Jun 1, 2017 Accepting new patients

Locations

5145 N California Ave
Chicago, IL 60625
Phone (773) 989-3800

9532 Eagle Way
Chicago, IL 60678

3122 N Ashland Ave
Chicago, IL 60657
Phone (773) 687-7000

5115 N Francisco Ave
Chicago, IL 60625
Phone (773) 271-2225

2740 W Foster Ave
Ste 310
Chicago, IL 60625

5140 N California Ave
Ste 780
Chicago, IL 60625
Phone (773) 784-5140

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

Interoperability endpoints

  • Direct secure messaging: ajohnson275267@direct.northshore.org

Organizations & group practices 4

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": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1386890150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 N FRANCISCO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253611",
            "telephone_number": "773-878-8200",
            "fax_number": "773-293-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 N FRANCISCO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253611",
            "telephone_number": "773-878-8200",
            "fax_number": "773-293-8804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2740 W Foster Ave",
            "address_2": "Ste 310",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606253500",
            "country_code": "US",
            "telephone_number": "773-878-8200 x6824",
            "fax_number": "773-293-8804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANDREW",
        "middle_name": "KELLY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-13",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "036.135367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajohnson275267@direct.northshore.org",
            "affiliation": "N",
            "address_1": "5115 N Francisco Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606253611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.