Dale Alan Johnson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

22410 Issued in WI

Practice address

820 Summit Ave
Prohealth Care Medical Associates FP
Oconomowoc, WI 53066-3973

Phone

(262) 567-0223

Fax

(262) 567-6380

NPI assigned

Mar 30, 2006

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

Enrolled in WI

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

Specialty

Family Practice

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Prohealth Home Care Home health agency, Waukesha, WI, CCN 527178
• Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008
• Oconomowoc Memorial Hospital Hospital, Oconomowoc, WI, CCN 520062

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: djohnson15518@direct.phci.org

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.

• Prohealth Medical Group Inc.

  • Pediatrics Physician
  • Waukesha, WI
  • NPI 1356322440

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Prohealth Medical Group Inc

  • Internal Medicine Physician
  • Oconomowoc, WI
  • NPI 1588706998

  Family Medicine

  NPD
• Prohealth Medical Group Inc

  • Family Medicine Physician
  • Waukesha, WI
  • NPI 1790720613
  NPD (past)

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

• Prohealth Home Care Inc

  • Home Health Agency
  • Waukesha, WI
  • NPI 1497720767
  Care Compare affiliation
• Prohealth Oconomowoc Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Oconomowoc, WI
  • NPI 1366420531
  Care Compare affiliation
• Prohealth Oconomowoc Memorial Hospital, Inc.

  • Community/Retail Pharmacy
  • Oconomowoc, WI
  • NPI 1497942205

  Hospital

  Care Compare affiliation
• Prohealth Waukesha Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Waukesha, WI
  • NPI 1629056890
  Care Compare affiliation

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1447211404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 SUMMIT AVE",
            "address_2": "PROHEALTH CARE MEDICAL ASSOCIATES FP",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530663973",
            "telephone_number": "262-567-0223",
            "fax_number": "262-567-6380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 SUMMIT AVE",
            "address_2": "PROHEALTH CARE MEDICAL ASSOCIATES FP",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530663973",
            "telephone_number": "262-567-0223",
            "fax_number": "262-567-6380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DALE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "22410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Palmira A Janusonis, M.D.
• Jeffery Ceschi, M.D., S.C.
• Jill P Wohlfeil MD SC
• Joanne Berthelsen LCSW LLC
• John T Bitner DDS LLC
• Jacob Johnson, PHARMD
• Kendra Johnson, ATC, LAT
• Jill Marie Johnston, PT
• Heather M Jones, PHD
• Gerald J. Kallas, M.D.

• Family Medicine Physician in Oconomowoc, WI
• Providers in Oconomowoc, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; 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.

Verify at the official NPI Registry.