Individual provider Active NPI

Andrew J Johnson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Detroit Lakes, MN
National Provider Identifier
1649281361
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
801 Issued in MN
Practice address
1245 S Washington Ave
Detroit Lakes, MN 56501-3905
Phone
(218) 846-2000
Fax
(218) 846-2114
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 801 MN
Foot & Ankle Surgery Podiatrist 213ES0103X 801 MN Primary
Podiatrist 213E00000X PO00000770 WA

Addresses

Primary practice location

1245 S Washington Ave
Detroit Lakes, MN 56501-3905

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-9419

Other identifiers 6

IdentifierTypeStateIssuer
8436453MedicaidWA
P00235433OtherWARAILROAD
0207841OtherWAL & I
8905370OtherWACRIME VICTIMS
0196122OtherWAL & I
8941204OtherWACRIME VICTIMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ajohnson1841377@direct.sanfordhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081104000501 MN Practitioner - Podiatry 3779523402 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
University of Iowa, RJ & L Carver College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

1000 Coney St W
Perham, MN 56573-2102
Phone (218) 347-1200

1245 Washington Ave
Detroit Lakes, MN 56501-3905
Phone (218) 846-2000

1412 Main St
Hawley, MN 56549
Phone (218) 483-3564

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.39 of 100Reported as group
Quality
91.62
Promoting interoperability
100
Improvement activities
40
Cost
66.36

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue22
Removal of skin lesions1-10
Removal of nail tissue69
Removal or shaving of skin growth23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO00000770WAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Jul 1, 2022 Accepting new patients
Perham Hospital District Current Accepting new patients
Sanford Medical Center Fargo CurrentSince Jul 1, 2022 Accepting new patients
Perham Hospital District Current Accepting new patients
Perham Hospital District CurrentSince Sep 14, 2024 Accepting new patients
Perham Hospital District CurrentSince Sep 14, 2024 Accepting new patients

Locations

1245 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 846-2000

4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200

115 E Soo St
Parkers Prairie, MN 56361
Phone (218) 338-4371

211 E Mill St
Pelican Rapids, MN 56572
Phone (218) 863-6100

1000 Coney St W
Perham, MN 56573
Phone (218) 347-1200

Interoperability endpoints

  • Direct secure messaging: ajohnson1841377@direct.sanfordhealth.org

Organizations & group practices 6

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 7

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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1649281361",
    "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": "605-328-9419",
            "fax_number": "605-312-9802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 S WASHINGTON AVE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013905",
            "telephone_number": "218-846-2000",
            "fax_number": "218-846-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANDREW",
        "middle_name": "J",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MN",
            "license": "801",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MN",
            "license": "801",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "PO00000770",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8436453",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00235433",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0207841",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8905370",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0196122",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8941204",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajohnson1841377@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "1245 S Washington Ave",
            "city": "Detroit Lakes",
            "state": "MN",
            "country_code": "US",
            "postal_code": "565013905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit Lakes, MN

Sources for this page

Verify at the official NPI Registry.