Individual provider Active NPI

Jared Alan Johnson, MD

  • Otolaryngology Physician
  • Royal Oak, MI
National Provider Identifier
1750819868
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
4301509749 Issued in MI
Practice address
3555 W 13 Mile Rd Ste N120
Royal Oak, MI 48073-6710
Phone
(248) 551-5700
NPI assigned
Jun 2, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X ME156683 FL
Otolaryngology Physician 207Y00000X 4301509749 MI Primary

Addresses

Primary practice location

3555 W 13 Mile Rd Ste N120
Royal Oak, MI 48073-6710

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-4352

Other practice location 1

540 E Canfield St
Detroit, MI 48201-1928
Phone (313) 577-1335

Other practice location 2

1120 NW 14th St Fl 5
Miami, FL 33136-2107
Phone (305) 243-3564

Other practice location 3

18100 Oakwood Blvd Ste 303
Dearborn, MI 48124-4085
Phone (313) 438-7998

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jjohnson6463674@direct.beaumont.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20230826000020 MI Practitioner - Otolaryngology 9830578160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Michigan State University College of Human Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

28100 Grand River Ave
Farmington Hills, MI 48336-5970

3555 W 13 Mile Rd
Royal Oak, MI 48073-6710

3577 W 13 Mile Rd
Royal Oak, MI 48073-6710

3581 W 13 Mile Rd BCC
Beaumont Breast Care Center
Royal Oak, MI 48073-6710
Phone (248) 551-3300

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

3601 W 13 Mile Rd Ec
Beaumont Emergency Services Ro
Royal Oak, MI 48073-6712
Phone (248) 898-5058

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.37 of 100Reported as group
Quality
66.73
Promoting interoperability
100
Improvement activities
40
Cost
70.98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301509749MIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Medical Group- Specialty Services CurrentSince Aug 21, 2023 Accepting new patients
University Physician Group Past Accepting new patients

Locations

18100 Oakwood Blvd
Ste 303
Dearborn, MI 48124
Phone (313) 438-5998

28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320

3555 W 13 Mile Rd
Ste N120
Royal Oak, MI 48073
Phone (248) 551-1550

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

Interoperability endpoints

  • Direct secure messaging: jjohnson1459197@epic00.shdirect.org
  • Direct secure messaging: jared.johnson.1@19711.direct.athenahealth.com

Organizations & group practices 2

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 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": "1496361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1750819868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-4352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 W 13 MILE RD STE N120",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736710",
            "telephone_number": "248-551-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "540 E Canfield St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482011928",
            "country_code": "US",
            "telephone_number": "313-577-1335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1120 NW 14th St Fl 5",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331362107",
            "country_code": "US",
            "telephone_number": "305-243-3564",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18100 Oakwood Blvd Ste 303",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481244085",
            "country_code": "US",
            "telephone_number": "313-438-7998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JARED",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-02",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME156683",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301509749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjohnson6463674@direct.beaumont.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3555 W 13 Mile Rd Ste N120",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.