Active NPI
Michael V Johnston, O.D.
- Optometrist
- Harlan, IA
National Provider Identifier
1740367283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 01898
- Practice address
- 2110 12TH St
Harlan, IA 51537-2056 - Phone
- (712) 755-2150
- Fax
- (712) 755-7555
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 01898 | IA | Primary |
Addresses
Primary practice location
2110 12TH St
Harlan, IA 51537-2056
Mailing address
2110 12TH St
Harlan, IA 51537-2056
Phone (712) 755-2150
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1284455 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Southern College of Optometry, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2110 12TH St
Harlan, IA 51537-2056
Phone (712) 755-2150
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 54 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01898 | IA | MD | Family Medicine Physician |
Interoperability endpoints
- mjohnston129314@uihcdirect.org
Organizations & group practices 1
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.
-
- Optometrist
- Harlan, IA
- NPI 1417131046
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211328000000",
"number": "1740367283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2110 12TH ST",
"city": "HARLAN",
"state": "IA",
"postal_code": "515372056",
"telephone_number": "712-755-2150",
"fax_number": "712-755-7555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2110 12TH ST",
"city": "HARLAN",
"state": "IA",
"postal_code": "515372056",
"telephone_number": "712-755-2150",
"fax_number": "712-755-7555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "MICHAEL",
"middle_name": "V",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2008-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IA",
"license": "01898",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1284455",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Harlan, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.