Mitzi Johnson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

59642 Issued in MA

Practice address

111 Grossman Dr
Braintree, MA 02184-4997

Phone

(781) 849-2300

Fax

(781) 849-2593

NPI assigned

Mar 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mitzi.johnson.1@27404.direct.athenahealth.com
• Direct secure messaging: mjohnsonmd159037@direct.atrius.masshiway.net

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.

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  Medicare reassignment NPD
• Medexpress Urgent Care, PC - Massachusetts

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• Pratt Pediatric Associates Inc

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  • NPI 1477590511
  Medicare reassignment NPD
• Actual Synergy Consulting

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  • NPI 1588891691
  NPD Authorized official
• Whole Person Health, LLC

  • General Practice Physician
  • Stoughton, MA
  • NPI 1306434576
  NPD Authorized official
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Sturbridge, MA
  • NPI 1386526192
  NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Newburyport, MA
  • NPI 1396436762
  NPD
• Medexpress Urgent Care, PC - Massachusetts

  • Urgent Care Clinic/Center
  • Springfield, MA
  • NPI 1134506488

  General Practice

  NPD

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1497887293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 GROSSMAN DR",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021844997",
            "telephone_number": "781-849-2300",
            "fax_number": "781-849-2593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 GROSSMAN DR",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021844997",
            "telephone_number": "781-849-2300",
            "fax_number": "781-849-2593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "430 Cooley St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011281180",
            "country_code": "US",
            "telephone_number": "413-782-0320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MITZI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MA",
            "license": "59642",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "59642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjohnsonmd159037@direct.atrius.masshiway.net",
            "affiliation": "N",
            "address_1": "111 Grossman Dr",
            "city": "Braintree",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021844997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katherine A Jin, MD
• John Scott House Rehabilitation & Nursing Center
• John Scott House, Inc
• Ashleigh Johnson
• Kayla Batista Johnson
• Reese Warner Johnson, MSW
• Cassandra Marie Jones
• Deanne Marie Jordan
• Naomi E Joress, NP
• Jackson Josaphat

• Pediatrics Physician in Braintree, MA
• Providers in Braintree, MA by specialty
• Pediatrics Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.