NPIMap

Individual provider Active NPI

Sonia Selene Ellisor Johnson, M.D.

  • Diagnostic Radiology Physician
  • Owings Mills, MD
National Provider Identifier
1598736951
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
D0061174 Issued in MD
Practice address
21 Crossroads Dr
Ste 100
Owings Mills, MD 21117-5441
Phone
(410) 356-8186
Fax
(410) 356-4180
NPI assigned
Feb 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X D0061174 MD Primary

Addresses

Primary practice location

21 Crossroads Dr
Ste 100
Owings Mills, MD 21117-5441

Mailing address

10373A Reisterstown Rd
Owings Mills, MD 21117-3617
Phone (410) 356-8186

Other identifiers 3

IdentifierTypeStateIssuer
J062OtherMDB/C B/S
2849OtherDCB/C B/S
KA80OtherMDB/C B/S

Other names 1

  • Sonia Selene Ellisor Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20210324001064 PA Practitioner - Diagnostic Radiology 7012907520 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Meharry Medical College School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1600 E High St
Pottstown, PA 19464-5008
Phone (610) 327-7485

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.32 of 100Reported as group
Quality
91.68
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62218CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Virtual Radiologic Professionals, LLC Diagnostic Radiology CurrentSince Feb 1, 2022 Accepting new patients
University Imaging Center, LLC Diagnostic Radiology Past Accepting new patients
Virtual Radiologic Professionals of Texas I, P.a. Diagnostic Radiology Past Accepting new patients
American Diagnostics Services LLC Diagnostic Radiology Past Accepting new patients
Symphony Diagnostic Services No 1 LLC Past Accepting new patients
University of Maryland Diagnostic Imaging Specialists P a Diagnostic Radiology Past Accepting new patients
University Imaging Center, LLC Diagnostic Radiology Past Accepting new patients

Locations

1600 E High St
Pottstown, PA 19464
Phone (610) 327-7485

Organizations & group practices 8

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1598736951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10373A REISTERSTOWN RD",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211173617",
            "telephone_number": "410-356-8186",
            "fax_number": "410-356-4180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 CROSSROADS DR",
            "address_2": "STE 100",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175441",
            "telephone_number": "410-356-8186",
            "fax_number": "410-356-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISOR JOHNSON",
        "first_name": "SONIA",
        "middle_name": "SELENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-01",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D0061174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B/C B/S",
            "identifier": "J062",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B/C B/S",
            "identifier": "2849",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B/C B/S",
            "identifier": "KA80",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SONIA",
            "last_name": "ELLISOR",
            "middle_name": "SELENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Owings Mills, MD

Sources for this page

Verify at the official NPI Registry.