Individual provider Active NPI

Aaron C Johansen, MD

  • Emergency Medicine Physician
  • Oka Tamuning, GU
National Provider Identifier
1639226863
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
M001271 Issued in GU
Practice address
850 Governor Carlos Camacho Road
Oka Tamuning, GU 96913-3128
Phone
(671) 647-2418
Fax
(671) 649-5508
NPI assigned
Jan 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X M001271 GU Primary

Addresses

Primary practice location

850 Governor Carlos Camacho Road
Oka Tamuning, GU 96913-3128

Mailing address

850 Governor Carlos Camacho Road
Oka Tamuning, GU 96913-3128
Phone (671) 647-2418

Other identifiers 1

IdentifierTypeStateIssuer
51510OtherPIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
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
I20111228000607 GU Practitioner - Emergency Medicine 2365618162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.81 of 100Reported as group
Quality
83.57
Improvement activities
40
Cost
76.16

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Guam Memorial Hospital CurrentSince Aug 1, 1998 Accepting new patients
Guam Memorial Hospital CurrentSince Aug 1, 1998 Accepting new patients

Locations

850 Gov Carlos G Camacho Rd
Tamuning, GU 96913
Phone (671) 647-2555

850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639226863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 GOVERNOR CARLOS CAMACHO ROAD",
            "city": "OKA TAMUNING",
            "state": "GU",
            "postal_code": "969133128",
            "telephone_number": "671-647-2418",
            "fax_number": "671-649-5508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 GOVERNOR CARLOS CAMACHO ROAD",
            "city": "OKA TAMUNING",
            "state": "GU",
            "postal_code": "969133128",
            "telephone_number": "671-647-2418",
            "fax_number": "671-649-5508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSEN",
        "first_name": "AARON",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GU",
            "license": "M001271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN",
            "identifier": "51510",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oka Tamuning, GU

Sources for this page

Verify at the official NPI Registry.