Individual provider Active NPI

Paul Erik Johnson, M.D.

  • Orthopaedic Surgery Physician
  • Port Saint Lucie, FL
National Provider Identifier
1407015712
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
ME132330 Issued in FL
Practice address
9077 S Federal Hwy
Port Saint Lucie, FL 34952-3405
Phone
(772) 335-4770
Fax
(772) 335-4133
NPI assigned
Jun 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X ME132330 FL Primary

Addresses

Primary practice location

9077 S Federal Hwy
Port Saint Lucie, FL 34952-3405

Mailing address

9077 S Federal Hwy
Port Saint Lucie, FL 34952-3405
Phone (772) 398-7336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170908003183 FL Practitioner - Orthopedic Surgery 3476826629 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Icahn School of Medicine at Mount Sinai, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

1550 Killingsworth Way
The Villages, FL 32162-2175
Phone (352) 633-2971

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mark J Powers MD PA Florida Orthopaedic Specialists Orthopaedic Surgery CurrentSince Aug 21, 2017 Accepting new patients
Florida Clinical Practice Association Inc Orthopaedic Surgery CurrentSince Nov 1, 2021 Accepting new patients
Florida Clinical Practice Association Inc Orthopaedic Surgery CurrentSince Nov 1, 2021 Accepting new patients
Mark J Powers MD PA Florida Orthopaedic Specialists Orthopaedic Surgery CurrentSince Aug 21, 2017 Accepting new patients

Locations

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

9077 S US Highway 1
Port St Lucie, FL 34952
Phone (407) 335-4770

Interoperability endpoints

  • Direct secure messaging: pjohnson@fos.gwaydirect.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1407015712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9077 S FEDERAL HWY",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349523405",
            "telephone_number": "772-398-7336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9077 S FEDERAL HWY",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349523405",
            "telephone_number": "772-335-4770",
            "fax_number": "772-335-4133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PAUL",
        "middle_name": "ERIK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-03",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME132330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.