Keith Patrick Johnson, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

25MA07819000 Issued in NJ

Practice address

85 Harristown Road
Suite 103
Glen Rock, NJ 07452

Phone

(844) 366-8800

Fax

(844) 366-8900

NPI assigned

Apr 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2021 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: keith.johnson@direct.hobokenumc.md

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.

• Humc Opco LLC

  • General Acute Care Hospital
  • Hoboken, NJ
  • NPI 1043475668
  NPD

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1487616967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 HARRISTOWN ROAD",
            "address_2": "SUITE 103",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "07452",
            "telephone_number": "844-366-8800",
            "fax_number": "844-366-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HARRISTOWN ROAD",
            "address_2": "SUITE 103",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "07452",
            "telephone_number": "844-366-8800",
            "fax_number": "844-366-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KEITH",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA07819000",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NJ",
            "license": "25MA07819000",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NJ",
            "license": "25MA07819000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kalista Concetta Javenes, OTR/L
• Jill Pharmacy Corp
• Jill Pharmacy Corp
• Jill Pharmacy Corp.
• JLB Counseling LLC
• Joyce Hayden-Seman, LLC
• Janet Melissa Kalina-Suarez, MA, CCC-SP.
• Nathaniel Kheysin, MD
• Samuel Eungook Kim
• Peter King, D.D.S.

• Orthopaedic Surgery Physician in Glen Rock, NJ
• Providers in Glen Rock, NJ by specialty
• Orthopaedic Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.