Philip Evan Preston Johnson, M. D.

Individual provider Active NPI Otolaryngology Physician · Rutledge, PA

NPI 1467418293 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1467418293
Entity type
Individual (NPI type 1)
Primary specialty
Otolaryngology Physician 207Y00000X
License
MD026166E (PA)
Practice address
127 Linden Ave
Rutledge, PA 19070-2102
Phone
(610) 543-8888
Fax
(610) 544-7612
NPI assigned
Apr 21, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Otolaryngology
Education
Temple University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

127 Linden Ave
Rutledge, PA 19070-2102
Phone (610) 543-8888

Hospital & facility affiliations

  • Riddle Memorial Hospital Hospital · Media, PA · CCN 390222
  • Main Line Hospital Lankenau Hospital · Wynnewood, PA · CCN 390195

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20141106000978 PA Practitioner - Otolaryngology 2769490994 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD026166EPAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Philip E. P. Johnson, MD, PC Otolaryngology Current
since Nov 6, 1984
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD026166E PA Yes

Addresses

Primary practice location

127 Linden Ave
Rutledge, PA 19070-2102

Mailing address

127 Linden Ave
Rutledge, PA 19070-2102
Phone (610) 543-8888

Other identifiers

IdentifierTypeStateIssuer
0975557MedicaidPA

Other providers in Rutledge, PA

All providers in Rutledge, PA · Otolaryngology Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.