Max Ray Johnson, MD

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

5573 Issued in ND

Practice address

4450 31St Ave S Ste 200
Fargo, ND 58104-4556

Phone

(701) 293-9829

Fax

(701) 293-0111

NPI assigned

Dec 19, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN, ND, UT, KS, HI5 enrollments

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 5

Specialty

Ophthalmology

Education

University of North Dakota School of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Retina Consultants, LTDGroup PAC ID 7618936568, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mjohnson@rcfargo.intellechartdirect.net
• Direct secure messaging: max.johnson.1@16708.direct.athenahealth.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.

• Retina Consultants, LTD

  • Retina Specialist (Ophthalmology) Physician
  • Fargo, ND
  • NPI 1972589182
  Medicare reassignment Care Compare group NPD
• Sanford Medical Center Fargo

  • Family Medicine Physician
  • West Fargo, ND
  • NPI 1184917924
  Medicare reassignment NPD
• Allina Health System

  • Family Medicine Physician
  • Annandale, MN
  • NPI 1457657249
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• Minuteclinic Diagnostic of Hawaii, L.L.C.

  • Family Nurse Practitioner
  • Kaneohe, HI
  • NPI 1720329923
  Medicare reassignment NPD
• Minuteclinic Diagnostic of Kansas PA

  • Family Nurse Practitioner
  • Leawood, KS
  • NPI 1629005558
  Medicare reassignment NPD
• Sanford Medical Center Fargo

  • Rural Health Clinic/Center
  • Lamoure, ND
  • NPI 1164439196
  NPD
• Sanford Medical Center Fargo

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1528009412
  NPD
• Allina Health System

  • Family Medicine Physician
  • St Paul, MN
  • NPI 1023314804
  NPD
• Allina Health System

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD
• Ihc Health Services Inc

  • Family Medicine Physician
  • Salina, UT
  • NPI 1538283163
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1679559975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 31ST AVE S STE 200",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044556",
            "telephone_number": "701-293-9829",
            "fax_number": "701-293-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 31ST AVE S STE 200",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044556",
            "telephone_number": "701-293-9829",
            "fax_number": "701-293-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MAX",
        "middle_name": "RAY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "ND",
            "license": "5573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjohnson@rcfargo.intellechartdirect.net",
            "affiliation": "N",
            "endpointDescription": "Send/receive CCDA only",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4450 31st Ave S Ste 200",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581044556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lucy M Johnson, CNS
• Mary A Johnson, LSW
• Mathew Johnson, PT, DPT
• Mattea Johnson, OTR/L
• Matthew Christopher Johnson, MD
• Meghan Johnson, DPT
• Melanie Kathryn Johnson, OTR/L
• Merrick Johnson, MD
• Michael S. Johnson, D.D.S.
• Miranda Jo Johnson, MS CCC-SLP

• Retina Specialist (Ophthalmology) Physician in Fargo, ND
• Providers in Fargo, ND by specialty
• Retina Specialist (Ophthalmology) Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.