Individual provider Active NPI

Sara Beth Kruger Johnson, M.D.

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1689875007
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
243064 Issued in NY
Practice address
1111 Amsterdam Ave
New York, NY 10025-1716
Phone
(212) 523-3981
NPI assigned
May 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 243064 NY Primary

Addresses

Primary practice location

1111 Amsterdam Ave
New York, NY 10025-1716

Mailing address

535 W 23Rd St
Apt N4D
New York, NY 10011-1120
Phone (917) 843-0714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20080729000286 CO Practitioner - Emergency Medicine 1557453321 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
40.82 of 100Reported as group
Quality
9.1
Promoting interoperability
100
Improvement activities
0
Cost
43.64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
243064NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gunnison Valley Hospital CurrentSince Jun 18, 2018 Accepting new patients
Gunnison Valley Hospital CurrentSince Jun 18, 2018 Accepting new patients
Gunnison Valley Hospital CurrentSince Dec 1, 2025 Accepting new patients
Gunnison Valley Hospital Current Accepting new patients
St Lukes Roosevelt Hospital Center Emergency Medicine Past Accepting new patients
Michael S Lippe MD, PC Past Accepting new patients

Locations

711 N Taylor St
Gunnison, CO 81230
Phone (970) 641-1456

707 N Iowa St
Gunnison, CO 81230
Phone (970) 641-1771

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.

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689875007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 W 23RD ST",
            "address_2": "APT N4D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100111120",
            "telephone_number": "917-843-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251716",
            "telephone_number": "212-523-3981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUGER JOHNSON",
        "first_name": "SARA",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "243064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.