NPIMap

Individual provider Active NPI

Paul E Johnson, MD

  • Diagnostic Radiology Physician
  • Taos, NM
National Provider Identifier
1750324232
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD2002-0304 Issued in NM
Practice address
1397 Weimer Rd
Taos, NM 87571-6253
Phone
(575) 758-8883
Fax
(303) 468-1394
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 20020304 NM
Vascular & Interventional Radiology Physician 2085R0204X MD2002-0304 NM
Diagnostic Radiology Physician 2085R0202X MD2002-0304 NM Primary

Addresses

Primary practice location

1397 Weimer Rd
Taos, NM 87571-6253

Mailing address

12687 W Cedar Dr
200
Lakewood, CO 80228-2014
Phone (303) 468-1395

Other identifiers 1

IdentifierTypeStateIssuer
82923884MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20040526000909 NM Practitioner - Diagnostic Radiology 4880675834 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Baylor College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Concord Radiology PLLCGroup PAC ID 8628332061, 217 clinicians

Practice addresses (Care Compare)

1397 Weimer Rd
Taos, NM 87571-6253
Phone (888) 264-0330

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.18 of 100Reported as group
Quality
85.58
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20020304NMMDSpecialist
MD2002-0304NMMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coaxion PLLC Diagnostic Radiology CurrentSince Dec 24, 2025 Accepting new patients
Taos Mountain Radiology Inc Diagnostic Radiology CurrentSince Nov 1, 2007 Accepting new patients
Imaging Associates of New Mexico LLC Diagnostic Radiology CurrentSince Jan 7, 2022 Accepting new patients
Taos Medical Imaging, PC Specialist Past Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients

Locations

12687 W Cedar Dr
Ste 200
Lakewood, CO 80228
Phone (303) 355-4674

3030 W Picacho Ave
Ste D
Las Cruces, NM 88007
Phone (575) 532-4427

104 Legion Dr
Las Vegas, NM 87701
Phone (505) 426-3500

1397 Weimer Rd
Taos, NM 87571
Phone (575) 751-5746

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1750324232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12687 W CEDAR DR",
            "address_2": "200",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802282014",
            "telephone_number": "303-468-1395",
            "fax_number": "303-468-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1397 WEIMER RD",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716253",
            "telephone_number": "575-758-8883",
            "fax_number": "303-468-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PAUL",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NM",
            "license": "20020304",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NM",
            "license": "MD2002-0304",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NM",
            "license": "MD2002-0304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82923884",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taos, NM

Sources for this page

Verify at the official NPI Registry.