NPIMap

Individual provider Active NPI

Glenn T. Johnson II, M.D.

  • Orthopaedic Surgery Physician
  • Evansville, IN
National Provider Identifier
1689672206
Registry record updated Jun 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
1048654 Issued in IN
Practice address
225 Crosslake Dr
Evansville, IN 47715-8198
Phone
(812) 477-1558
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X 1048654 IN
Orthopaedic Surgery Physician 207X00000X 1048654 IN Primary

Addresses

Primary practice location

225 Crosslake Dr
Evansville, IN 47715-8198

Mailing address

225 Crosslake Dr
Evansville, IN 47715-8198
Phone (812) 477-1558

Other identifiers 1

IdentifierTypeStateIssuer
200238020AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20100312001025 IN Practitioner - Orthopedic SurgeryPractitioner - Hand Surgery 2961397914 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Hand Surgery
Education
University of Kentucky College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians
Orthopaedics-Indianapolis IncGroup PAC ID 7416860663, 357 clinicians

Practice addresses (Care Compare)

1050 Old Camp Rd
The Villages, FL 32162-1762
Phone (352) 693-3378

225 Crosslake Dr
Evansville, IN 47715-8198
Phone (812) 477-1558

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
66.6 of 100Reported as group
Quality
60.71
Promoting interoperability
33
Improvement activities
40
Cost
83.78

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)38
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1048654INMDOrthopaedic Hand Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedics-Indianapolis, Inc Orthopaedic Surgery Current Accepting new patients
Orthopaedics-Indianapolis, Inc Orthopaedic Surgery CurrentSince Jul 1, 2025 Accepting new patients
Orthopaedics-Indianapolis, Inc Orthopaedic Surgery CurrentSince Jul 1, 2025 Accepting new patients

Locations

225 Crosslake Dr
Evansville, IN 47715
Phone (812) 471-6677

5625 Pearl Dr
Ste 101
Evansville, IN 47712
Phone (812) 474-3800

8450 Northwest Blvd
Indianapolis, IN 46278

Interoperability endpoints

  • Direct secure messaging: 07johg@tsos.srs-direct.com

Organizations & group practices 4

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 9

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498176000000",
    "number": "1689672206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 CROSSLAKE DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477158198",
            "telephone_number": "812-477-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 CROSSLAKE DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477158198",
            "telephone_number": "812-477-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GLENN",
        "middle_name": "T.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2017-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "IN",
            "license": "1048654",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "1048654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200238020A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.