NPIMap

Individual provider Active NPI

Michael D Johnson, MD

  • Internal Medicine Physician
  • Sheboygan, WI
National Provider Identifier
1689642845
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
42241020 Issued in WI
Practice address
2920 Superior Ave
Sheboygan, WI 53081-1944
Phone
(920) 453-5410
Fax
(920) 803-2990
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 42241020 WI Primary

Addresses

Primary practice location

2920 Superior Ave
Sheboygan, WI 53081-1944

Mailing address

2920 Superior Ave
Sheboygan, WI 53081-1944
Phone (920) 453-5410

Other identifiers 1

IdentifierTypeStateIssuer
34048800MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060328000308 WI Practitioner - Internal Medicine 1254363807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ohio State University College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheboygan Physicians Group S.C.Group PAC ID 0648435214, 15 clinicians

Practice addresses (Care Compare)

2920 Superior Ave
Sheboygan, WI 53081-1944
Phone (920) 452-6000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42241020WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sheboygan Internal Medicine Associates, SC Internal Medicine Current Accepting new patients
Sheboygan Physicians Group, SC Internal Medicine CurrentSince Jul 1, 2012 Accepting new patients
Sheboygan Surgical Associates, S.C. Current Accepting new patients

Locations

2920 Superior Ave
Sheboygan, WI 53081
Phone (920) 452-6000

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Organizations & group practices 3

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 12

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1689642845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 SUPERIOR AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530811944",
            "telephone_number": "920-453-5410",
            "fax_number": "920-803-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 SUPERIOR AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530811944",
            "telephone_number": "920-453-5410",
            "fax_number": "920-803-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "42241020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34048800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

Verify at the official NPI Registry.