Blake A Johnson, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

39490 Issued in MN

Practice address

5775 Wayzata Blvd
Ste 190
St Louis Park, MN 55416

Phone

(952) 541-1840

Fax

(952) 513-6880

NPI assigned

Mar 7, 2006

Last updated

Feb 17, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Diagnostic Radiology

Education

University of Minnesota Medical School, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Scanning Consultants PAGroup PAC ID 9032005376, 82 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Medical Scanning Consultants PA

  dba RAYUS Radiology

  • Diagnostic Radiology Physician
  • St Louis Park, MN
  • NPI 1659348092
  Medicare reassignment Care Compare group NPD
• Radiology Associates of the Fox Valley, SC

  • Diagnostic Radiology Physician
  • Neenah, WI
  • NPI 1477539443

  MN

  Medicare reassignment NPD
• Cdi Twin Cities ASC LLC

  dba Rayus Twin Cities ASC

  • Ambulatory Surgical Clinic/Center
  • St Louis Park, MN
  • NPI 1245207687
  NPD
• Medical Scanning Consultants, PA

  dba Rayus Radiology

  • Diagnostic Radiology Physician
  • Eden Prairie, MN
  • NPI 1699706176
  NPD
• Medical Scanning Consultants PA

  dba RAYUS Radiology

  • Diagnostic Radiology Physician
  • Federal Way, WA
  • NPI 1730156175
  NPD
• Medical Scanning Consultants PA

  dba Rayus Radiology

  • Diagnostic Radiology Physician
  • Oviedo, FL
  • NPI 1871560201
  NPD (past)
• Medical Scanning Consultants, P.a.

  dba Rayus Radiology

  • Diagnostic Radiology Physician
  • Wauwatosa, WI
  • NPI 1811919426
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1811964174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1450",
            "address_2": "NW6035",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554856035",
            "telephone_number": "952-542-8553",
            "fax_number": "952-513-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD",
            "address_2": "STE 190",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "55416",
            "telephone_number": "952-541-1840",
            "fax_number": "952-513-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BLAKE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "39490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205022600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittney Marie Joachim, CNP
• Aimee E Johnson, MD
• Alvin Johnson
• Angela Marie Johnson, P.T.
• Anna Lynn Johnson, APRN CNP
• Christopher Johnson, MD
• Elizabeth M Johnson, OD
• Elliot Mohr Johnson, MD
• Heather J Johnson, PSYD
• Jeffrey Randall Johnson, MD

• Diagnostic Radiology Physician in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Diagnostic Radiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.