NPIMap

Individual provider Active NPI

Nicholas C Johnson, MD

  • Emergency Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1396711446
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
46217 Issued in MN
Practice address
800 E 28TH St # Mr 11112
Minneapolis, MN 55407-3723
Phone
(612) 863-4233
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 46217 MN Primary

Addresses

Primary practice location

800 E 28TH St # Mr 11112
Minneapolis, MN 55407-3723

Mailing address

2829 University Ave SE Ste 730
Minneapolis, MN 55414-3279
Phone (612) 439-1860

Other identifiers 1

IdentifierTypeStateIssuer
941453300MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040506000698 MN Practitioner - Emergency Medicine 7113916107 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Creighton University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

2855 Campus Dr
Plymouth, MN 55441-2649
Phone (763) 577-7160

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 863-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95.56
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ecc Addiction & Toxicology Services LLC CurrentSince Jul 3, 2022 Accepting new patients
Emergency Care Consultants, PA Emergency Medicine CurrentSince Sep 1, 2004 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Aug 26, 2009 Accepting new patients
Allina Health System CurrentSince Aug 26, 2009 Accepting new patients
Allina Health System Past Accepting new patients
Group Health, Inc. Past Accepting new patients

Locations

200 State Ave
Faribault, MN 55021
Phone (507) 334-6451

1175 Nininger Rd
Hastings, MN 55033
Phone (651) 404-1000

2829 University Ave SE
Ste 730
Minneapolis, MN 55414
Phone (612) 439-1868

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

800 E 28th St
#11112
Minneapolis, MN 55407
Phone (612) 863-4233

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2250 NW 26th St
Owatonna, MN 55060
Phone (507) 451-3850

2855 Campus Dr
Plymouth, MN 55441
Phone (763) 577-7000

333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256

640 Jackson St
#11102F
Saint Paul, MN 55101
Phone (651) 254-3456

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

360 Sherman St
Ste 160
Saint Paul, MN 55102
Phone (651) 241-7200

Organizations & group practices 7

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 29

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1396711446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 UNIVERSITY AVE SE STE 730",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143279",
            "telephone_number": "612-439-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST # MR 11112",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "612-863-4233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NICHOLAS",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "46217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "941453300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.