Individual provider Active NPI

Michael W. Johansen, D.O.

  • Pediatric Cardiology Physician
  • Indianapolis, IN
National Provider Identifier
1578772158
Registry record updated Feb 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
02003367 Issued in IN
Practice address
705 Riley Hospital Dr
Ri 1134
Indianapolis, IN 46202-5109
Phone
(317) 944-8906
Fax
(317) 944-9330
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 02003367 IN Primary

Addresses

Primary practice location

705 Riley Hospital Dr
Ri 1134
Indianapolis, IN 46202-5109

Mailing address

PO Box 719094
Chicago, IL 60677-9318
Phone (317) 777-6435

Other identifiers 1

IdentifierTypeStateIssuer
201077240MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MJOHANS1@direct.iuhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20120725000928 IN Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 0648436204 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Pediatric Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Pediatric Associates IncGroup PAC ID 2163326794, 100 clinicians
Iu Health Medical Group Riley Specialists LLCGroup PAC ID 9638669815, 285 clinicians

Practice addresses (Care Compare)

705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Phone (317) 944-5000

Hospital & facility affiliations

  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02003367INMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatric Associates, Inc. CurrentSince Aug 1, 2012 Accepting new patients
Iu Health Medical Group Riley Specialists, LLC CurrentSince Jan 1, 2026 Accepting new patients
The Health and Hospital Corporation of Marion County CurrentSince Oct 6, 2025 Accepting new patients
The Health and Hospital Corporation of Marion County CurrentSince Oct 6, 2025 Accepting new patients
Major Hospital Past Accepting new patients

Locations

575 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 944-3966

705 Riley Hospital Dr
#127
Indianapolis, IN 46202
Phone (317) 274-8906

705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779

705 Riley Hospital Dr
#1134
Indianapolis, IN 46202
Phone (317) 944-8906

720 Eskenazi Ave
Indianapolis, IN 46202
Phone (317) 880-0000

Interoperability endpoints

  • Direct secure messaging: mjohans1@direct.iuhealth.org

Organizations & group practices 5

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 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1578772158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 719094",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606779318",
            "telephone_number": "317-777-6435",
            "fax_number": "317-777-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 RILEY HOSPITAL DR",
            "address_2": "RI 1134",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025109",
            "telephone_number": "317-944-8906",
            "fax_number": "317-944-9330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSEN",
        "first_name": "MICHAEL",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "IN",
            "license": "02003367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201077240",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MJOHANS1@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "705 Riley Hospital Dr",
            "address_2": "RI 1134",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.