Matthew Joseph Johnson, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

016 004881 Issued in IL

Practice address

2090 Larkin Ave
Elgin, IL 60123-5845

Phone

(847) 931-9212

Fax

(847) 222-7852

NPI assigned

Mar 7, 2007

Last updated

Dec 30, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

William M. Scholl College of Podiatric Medicine, 1997

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alan M. Polse D.D.S. & Associates, LTD.

  • General Practice Dentistry
  • Elgin, IL
  • NPI 1174570048
  NPD (past)
• Michael D. Johnson, D.D.S.,P.C.

  • Dental Clinic/Center
  • Elgin, IL
  • NPI 1477801298
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1538290218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 LARKIN AVE",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601235845",
            "telephone_number": "847-931-9212",
            "fax_number": "847-222-7852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 LARKIN AVE",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601235845",
            "telephone_number": "847-931-9212",
            "fax_number": "847-222-7852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MATTHEW",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016 004881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005115612",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0210272",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED AMERICAN INSURANCE",
            "identifier": "C 518820",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIEL",
            "identifier": "0001623386",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jodi M Fourt
• Ellen Patricia Johnson
• Geraldine Anne Johnson, RN
• Jennifer Johnson, MHP
• John Barnette Johnson III, MS DC
• Michael David Johnson, D.D.S.
• Oletha Johnson, NP
• Rotimi Johnson, MD
• Tatiana Johnson
• Jon a Sunderlage Professional Corp

• Podiatrist in Elgin, IL
• Providers in Elgin, IL by specialty
• Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; 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.