Individual provider Active NPI

Peter Johnson, DO

  • Family Medicine Physician
  • Blue Bell, PA
National Provider Identifier
1568925394
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS021752 Issued in PA
Practice address
325 Sentry Pkwy E BLDG 5W
Blue Bell, PA 19422-2312
Phone
(954) 399-4673
NPI assigned
Apr 9, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X OS021752 PA
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X
Family Medicine Physician 207Q00000X OS021752 PA Primary

Addresses

Primary practice location

325 Sentry Pkwy E BLDG 5W
Blue Bell, PA 19422-2312

Mailing address

3601 SW 160TH Ave Ste 250
Miramar, FL 33027-6314
Phone (954) 399-4673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20230105002340 PA Practitioner - Family Practice 7517293319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS021752PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vohra Post Acute Care Physicians of the Northeast PA Single Specialty CurrentSince Dec 5, 2022 Accepting new patients

Locations

3601 SW 160th Ave
Ste 250
Miramar, FL 33027
Phone (305) 866-9951

325 Sentry Pkwy E
Bldg 5W
Blue Bell, PA 19422
Phone (484) 664-8181

325 Sentry Pkwy
Bldg 5
Blue Bell, PA 19422
Phone (610) 277-3430

867 York Rd
Gettysburg, PA 17325
Phone (717) 337-3238

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.

NPI Registry JSON

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1568925394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 SW 160TH AVE STE 250",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330276314",
            "telephone_number": "954-399-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 SENTRY PKWY E BLDG 5W",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194222312",
            "telephone_number": "954-399-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PETER",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PA",
            "license": "OS021752",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS021752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Bell, PA

Sources for this page

Verify at the official NPI Registry.