Sandra Marchese Johnson, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

E-1554 Issued in AR

Practice address

5921 Riley Park Dr
Fort Smith, AR 72916-6103

Phone

(479) 420-1221

Fax

(479) 646-0133

NPI assigned

Jun 27, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 1

Other names 1

• Sandra Marie Marchese Former name

Medicare fee-for-service enrollment

Enrolled in AR

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

Dermatology

Education

Northeastern Ohio University College of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Johnson Dermatology Clinic PLLCGroup PAC ID 4789688615, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health - Fort Smith Hospital, Fort Smith, AR, CCN 040055
• Mena Regional Health System Hospital, Mena, AR, CCN 041334

Merit-based Incentive Payment System (MIPS)

Final score

84.81 of 100Reported as group

Quality

82.93

Improvement activities

40

Cost

72.14

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Johnson Dermatology Clinic PLLC

  • Dermatology Physician
  • Fort Smith, AR
  • NPI 1437110962
  Medicare reassignment Care Compare group NPD Authorized official

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

• Baptist Health Regional Hospitals

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1710463146
  Care Compare affiliation
• Mena Hospital Commission

  • Critical Access Hospital
  • Mena, AR
  • NPI 1861449639
  Care Compare affiliation

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1447256102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5921 RILEY PARK DR",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729166103",
            "telephone_number": "479-420-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5921 RILEY PARK DR",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729166103",
            "telephone_number": "479-420-1221",
            "fax_number": "479-646-0133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "195 highway 64",
            "address_purpose": "LOCATION",
            "city": "Alma",
            "state": "AR",
            "postal_code": "72921",
            "country_code": "US",
            "telephone_number": "479-649-3376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SANDRA",
        "middle_name": "MARCHESE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-27",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "AR",
            "license": "E1554",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "AR",
            "license": "E-1554",
            "primary": false
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "AR",
            "license": "E-1554",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "AR",
            "license": "E1554",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "AR",
            "license": "E-1554",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AR",
            "license": "E-1554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139972001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "MARCHESE",
            "middle_name": "MARIE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joanne Johnson, APRN
• Jory Johnson, DO
• Joshua Johnson
• Lee Morgan Johnson, MD
• Maya'Neisha Johnson, QBHP/MHPP
• Shannan Johnson, NP STUDENT
• Shelley Lynn Johnson
• Shelly Johnson, APRN
• Teresa Johnson, MHPP
• Tierra L Johnson, QBHP

• Dermatology Physician in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Dermatology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.