Individual provider Active NPI

Thomas Mark Johnson, M.D.

  • Cardiovascular Disease Physician
  • Dubuque, IA
National Provider Identifier
1801848486
Registry record updated Nov 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
21505 Issued in IA
Practice address
1000 Langworthy St
Dubuque, IA 52001-7313
Phone
(563) 584-3425
Fax
(563) 584-3497
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 21505 IA Primary
Cardiovascular Disease Physician 207RC0000X 29644 WI

Addresses

Primary practice location

1000 Langworthy St
Dubuque, IA 52001-7313

Mailing address

1500 Associates Dr
Dubuque, IA 52002-2201
Phone (563) 584-4100

Other identifiers 1

IdentifierTypeStateIssuer
0160531MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100305000461 IA Practitioner - Cardiovascular Disease (Cardiology) 7214912401 Reassigns benefits to 1 organization
I20101113000206 WI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 7214912401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Iowa, RJ & L Carver College of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates Clinic P CGroup PAC ID 3870491228, 228 clinicians

Practice addresses (Care Compare)

1000 Langworthy St
Dubuque, IA 52001-7313
Phone (563) 584-4100

1240 Big Jack Rd
Platteville, WI 53818-8902
Phone (608) 348-6266

250 Mercy Dr
Dubuque, IA 52001-7320
Phone (563) 584-8000

Hospital & facility affiliations

  • Mercyone Dubuque Medical Center Hospital, Dubuque, IA, CCN 160069
  • Mercyone Elkader Medical Center Hospital, Elkader, IA, CCN 161319

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21505IAMDCardiovascular Disease Physician
29644WIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
Medical Associates Clinic P C CurrentSince Aug 2, 1979 Accepting new patients

Locations

1500 Associates Dr
Dubuque, IA 52002
Phone (563) 584-4100

1000 Langworthy St
Dubuque, IA 52001
Phone (563) 584-3455

200 Main St
Guttenberg, IA 52052
Phone (563) 252-1121

9177 Old Potosi Rd
Lancaster, WI 53813
Phone (608) 723-4300

1240 Big Jack Rd
Platteville, WI 53818
Phone (608) 348-2844

Interoperability endpoints

  • Direct secure messaging: tjohnson141994@direct.unitypoint.org

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.

Hospital & facility affiliations 2

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259107200000",
    "number": "1801848486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ASSOCIATES DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520022201",
            "telephone_number": "563-584-4100",
            "fax_number": "563-584-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LANGWORTHY ST",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520017313",
            "telephone_number": "563-584-3425",
            "fax_number": "563-584-3497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "THOMAS",
        "middle_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2009-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IA",
            "license": "21505",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "29644",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0160531",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

Verify at the official NPI Registry.