Individual provider Active NPI

Philip Johnson, MD

  • Anesthesiology Physician
  • Denver, CO
National Provider Identifier
1790750339
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G5939 Issued in TX
Practice address
455 Sherman St
Ste 510
Denver, CO 80203-4400
Phone
(303) 377-6825
Fax
(303) 780-0787
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 39926 CO
Anesthesiology Physician 207L00000X G5939 TX Primary

Addresses

Primary practice location

455 Sherman St
Ste 510
Denver, CO 80203-4400

Mailing address

455 Sherman St
Ste 510
Denver, CO 80203-4400
Phone (303) 377-6825

Other identifiers 1

IdentifierTypeStateIssuer
50932535MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address philip.johnson@direct.myteamcare.com

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
I20210707000598 TX Practitioner - Anesthesiology 2365638350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Tech University Health Sciences Center LubbockGroup PAC ID 4385549674, 363 clinicians

Practice addresses (Care Compare)

3601 4TH St
1B350K
Lubbock, TX 79430-8182
Phone (806) 743-2981

Hospital & facility affiliations

  • University Medical Center Hospital, Lubbock, TX, CCN 450686

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
87.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39926COMDAnesthesiology Physician
G5939TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Jul 1, 2021 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Anesthesiology CurrentSince Jul 1, 2021 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Beaumont Hospital Holdings Inc Past Accepting new patients
Metro Denver Anesthesia PC Anesthesiology Past Accepting new patients

Locations

3601 4th St
#1B350K
Lubbock, TX 79430
Phone (806) 743-2981

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

Organizations & group practices 5

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 5

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1790750339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 SHERMAN ST",
            "address_2": "STE 510",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802034400",
            "telephone_number": "303-377-6825",
            "fax_number": "303-780-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 SHERMAN ST",
            "address_2": "STE 510",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802034400",
            "telephone_number": "303-377-6825",
            "fax_number": "303-780-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PHILIP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "39926",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "G5939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50932535",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "philip.johnson@direct.myteamcare.com",
            "affiliation": "N",
            "address_1": "3601 4th St",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794300002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.