Dylan Johnston

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1111 W 17TH St
Tulsa, OK 74107-1886

Phone

(918) 561-1145

NPI assigned

Aug 16, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: djohnston484561@direct.integrisok.com

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.

• Integris Ambulatory Care Corporation

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1750333936

  OK

  Medicare reassignment Care Compare group
• Integris Ambulatory Care C Orporation

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1326076027
  NPD (past)

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

• Integris Baptist Medical Center Inc

  • Psychiatric Hospital Unit
  • Oklahoma City, OK
  • NPI 1598837221

  Hospital

  Care Compare affiliation
• Integris Baptist Medical Center Inc

  • Psychiatric Hospital Unit
  • Spencer, OK
  • NPI 1659443372

  Hospital

  Care Compare affiliation
• Integris Baptist Medical Center Inc

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1831103654

  Hospital

  Care Compare affiliation
• Integris Baptist Medical Center Inc

  • Psychiatric Hospital Unit
  • Spencer, OK
  • NPI 1881760759

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1609594787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17765 W TRIPLETT RD",
            "city": "CASHION",
            "state": "OK",
            "postal_code": "730169694",
            "telephone_number": "405-708-8992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W 17TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741071886",
            "telephone_number": "918-561-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "DYLAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trey A Johnson, DO
• Wade Russell Johnson, DO
• Wakie I Johnson, LPC
• Wyatt McCuiston Johnson
• Amanda Renae Johnston, B.S.
• Jonathon Ryan Johnston, DO
• Kayla Johnston
• Lisa Diane Johnston, NP
• Mattie Grace Johnston
• Nathan Erik-James Johnston, EDD

• All providers in Tulsa, OK
• Student in an Organized Health Care Education/Training Program in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.