NPIMap

Individual provider Active NPI

Peter David Johnson, MD

  • Physical Medicine & Rehabilitation Physician
  • Sioux Falls, SD
National Provider Identifier
1588660393
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
4108 Issued in SD
Practice address
1210 W 18TH St
Ste 100
Sioux Falls, SD 57104-9890
Phone
(605) 312-8500
Fax
(605) 312-8501
NPI assigned
Jun 27, 2005
Last updated
Mar 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 4108 SD Primary

Addresses

Primary practice location

1210 W 18TH St
Ste 100
Sioux Falls, SD 57104-9890

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-9556

Other identifiers 1

IdentifierTypeStateIssuer
6100182MedicaidSD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pjohnson6691@direct.sanfordhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040827000003 SD Practitioner - Physical Medicine and Rehabilitation 9931174679 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Sanford School of Medicine of University of South Dakota, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical CenterGroup PAC ID 8325950215, 847 clinicians

Practice addresses (Care Compare)

1301 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 312-2200

1305 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 312-7300

4405 E 26TH St
Sioux Falls, SD 57103-4187
Phone (605) 332-2883

901 4TH St NW
Watertown, SD 57201-1558
Phone (605) 886-8471

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.78 of 100Reported as group
Quality
78.77
Promoting interoperability
100
Improvement activities
40
Cost
70.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4108SDMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Physical Medicine & Rehabilitation CurrentSince Feb 1, 2012 Accepting new patients
Sanford Clinic CurrentSince Feb 1, 2002 Accepting new patients
Sanford Clinic CurrentSince Feb 1, 2002 Accepting new patients
Sanford Clinic Current Accepting new patients
Sanford Clinic Past Accepting new patients
Sanford Clinic Past Accepting new patients
Sanford Medical Center Past Accepting new patients

Locations

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

1210 W 18th St
Ste 100
Sioux Falls, SD 57104
Phone (605) 312-8500

1305 W 18th St
Sioux Falls, SD 57105
Phone (605) 312-7300

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

901 4th St NW
Watertown, SD 57201
Phone (605) 882-8780

Interoperability endpoints

  • Direct secure messaging: pjohnson6691@direct.sanfordhealth.org

Organizations & group practices 7

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.

Hospital & facility affiliations 6

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": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1588660393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-9556",
            "fax_number": "605-328-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W 18TH ST",
            "address_2": "STE 100",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571049890",
            "telephone_number": "605-312-8500",
            "fax_number": "605-312-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PETER",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "SD",
            "license": "4108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6100182",
            "state": "SD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pjohnson6691@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "1210 W 18th St",
            "address_2": "Ste 100",
            "city": "Sioux Falls",
            "state": "SD",
            "country_code": "US",
            "postal_code": "571049890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.