Individual provider Active NPI

Nathan Samuel Johnson, M.D.

  • Diagnostic Radiology Physician
  • Cleveland, OH
National Provider Identifier
1609997121
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
35C.002526 Issued in OH
Practice address
9500 Euclid Ave
Cleveland, OH 44195-5350
Phone
(913) 231-5161
NPI assigned
Apr 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 04-35584 KS
Diagnostic Radiology Physician 2085R0202X 2012009153 MO
Diagnostic Radiology Physician 2085R0202X ME173377 FL
Diagnostic Radiology Physician 2085R0202X 35C.002526 OH Primary

Addresses

Primary practice location

9500 Euclid Ave
Cleveland, OH 44195-5350

Mailing address

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (913) 231-5161

Other practice location 1

20333 W 151st St
Olathe, KS 66061-5350
Phone (913) 791-4291

Other identifiers 5

IdentifierTypeStateIssuer
200877220AMedicaidKS
P01094625OtherKSRR MEDICARE
P01119931OtherMORR MEDICARE
200877220BMedicaidKS
P01115725OtherKSRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20121018000130 MO Practitioner - Diagnostic Radiology 1254509458 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Kansas School of Med (KC/Wich/Sal), 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3620 NW Primrose LN
Lees Summit, MO 64064-1889
Phone (913) 231-5161

Hospital & facility affiliations

  • Hillcrest Hospital Hospital, Mayfield Heights, OH, CCN 360230
  • Fairview Hospital Hospital, Cleveland, OH, CCN 360077
  • Cleveland Clinic Hospital Hospital, Weston, FL, CCN 100289
  • Cleveland Clinic Indian River Hospital Hospital, Vero Beach, FL, CCN 100105
  • Cleveland Clinic Avon Hospital Hospital, Avon, OH, CCN 360364

Merit-based Incentive Payment System (MIPS)

Final score
69.76 of 100Reported as group
Quality
46.12
Promoting interoperability
100
Improvement activities
40
Cost
53.08

Merit-based Incentive Payment System (MIPS)

Final score
87.1 of 100Reported as group
Quality
88.62
Improvement activities
40
Cost
77.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME173377FLMDDiagnostic Radiology Physician
04-35584KSMDDiagnostic Radiology Physician
2012009153MOMDDiagnostic Radiology Physician
35C.002526OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Excelsior Springs City Hospital CurrentSince Dec 1, 2024 Accepting new patients
Cleveland Clinic Health Services Professional Association, Inc CurrentSince May 21, 2025 Accepting new patients
Excelsior Springs City Hospital Current Accepting new patients

Locations

1700 Rainbow Blvd
Exclsor Sprgs, MO 64024

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

Interoperability endpoints

  • Direct secure messaging: njohnson755642@direct.kuha.org

Organizations & group practices 4

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 5

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1609997121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "913-231-5161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441955350",
            "telephone_number": "913-231-5161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20333 W 151st St",
            "address_purpose": "LOCATION",
            "city": "Olathe",
            "state": "KS",
            "postal_code": "660615350",
            "country_code": "US",
            "telephone_number": "913-791-4291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NATHAN",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KS",
            "license": "04-35584",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2012009153",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME173377",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35C.002526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200877220A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01094625",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01119931",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200877220B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01115725",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.