Individual provider Active NPI

Thomas W Johnson, MD

  • Surgery Physician
  • Southbridge, MA
National Provider Identifier
1659476182
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
216119 Issued in MA
Practice address
100 South St
Suite 108
Southbridge, MA 01550-4051
Phone
(508) 764-6966
Fax
(508) 764-2457
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 216119 MA Primary

Addresses

Primary practice location

100 South St
Suite 108
Southbridge, MA 01550-4051

Mailing address

PO Box 40
Southbridge, MA 01550-0040
Phone (508) 909-7799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20101117001029 MA Practitioner - General Surgery 9335334200 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Pennsylvania, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

100 S St
Southbridge, MA 01550-4051
Phone (508) 765-9771

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy24
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
216119MAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc Surgery CurrentSince Oct 1, 2023 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Oct 1, 2023 Accepting new patients
Umass Memorial Health-Harrington Hospital Inc CurrentSince Nov 2, 2015 Accepting new patients
Beverly Surgical Associates Inc Surgery CurrentSince Sep 11, 2000 Accepting new patients
Northeast Hospital Corporation Past Accepting new patients

Locations

75 Herrick St
Ste 201
Beverly, MA 01915
Phone (978) 816-2589

40 Wright St
Palmer, MA 01069
Phone (413) 284-5210

100 South St
Ste 102
Southbridge, MA 01550
Phone (508) 765-7860

100 South St
Southbridge, MA 01550
Phone (508) 764-8012

100 South St
Ste 108
Southbridge, MA 01550
Phone (508) 764-6966

94 South St
Southbridge, MA 01550
Phone (508) 764-2772

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

340 Thompson Rd
Webster, MA 01570
Phone (508) 943-2600

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: thomasjohnson@hps.allscriptsdirect.net

Organizations & group practices 5

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 1

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1659476182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015500040",
            "telephone_number": "508-909-7799",
            "fax_number": "508-764-2432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SOUTH ST",
            "address_2": "SUITE 108",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015504051",
            "telephone_number": "508-764-6966",
            "fax_number": "508-764-2457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "THOMAS",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "216119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbridge, MA

Sources for this page

Verify at the official NPI Registry.