Individual provider Active NPI

Mariana Murguia Johnson, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Bedford, TX
National Provider Identifier
1790129385
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
R1394 Issued in TX
Practice address
2001 Forest Ridge Dr
Bedford, TX 76021-5712
Phone
(214) 444-8665
Fax
(506) 499-9518
NPI assigned
Apr 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X R1394 TX Primary

Addresses

Primary practice location

2001 Forest Ridge Dr
Bedford, TX 76021-5712

Mailing address

103 River Rd Ste 101
Edgewater, NJ 07020-1016
Phone (201) 654-6397

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170921000162 TX Practitioner - Physical Medicine and Rehabilitation 7618268756 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1394TXMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 16, 2017 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Physical Medicine & Rehabilitation CurrentSince Aug 16, 2017 Accepting new patients

Locations

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

2655 Villa Creek Dr
Farmers Branch, TX 75234
Phone (214) 736-8376

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 3

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": "1366848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1790129385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 RIVER RD STE 101",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201016",
            "telephone_number": "201-654-6397",
            "fax_number": "506-499-9518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 FOREST RIDGE DR",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215712",
            "telephone_number": "214-444-8665",
            "fax_number": "506-499-9518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARIANA",
        "middle_name": "MURGUIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-25",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "R1394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

Verify at the official NPI Registry.