NPIMap

Individual provider Active NPI

Michael Paul Johnson, M.D.

  • Obstetrics & Gynecology Physician
  • Lakewood, CO
National Provider Identifier
1821197476
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
35786 Issued in CO
Practice address
255 Union Blvd
Ste 200
Lakewood, CO 80228-1810
Phone
(303) 763-5111
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 35786 CO Primary

Addresses

Primary practice location

255 Union Blvd
Ste 200
Lakewood, CO 80228-1810

Mailing address

255 Union Blvd
Ste 200
Lakewood, CO 80228-1810
Phone (303) 763-5111

Other identifiers 1

IdentifierTypeStateIssuer
01357862MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060215000627 CO Practitioner - Gynecological Oncology 0143235937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gynecological Oncology
Education
Creighton University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
OB-GYN AffiliatesGroup PAC ID 6608765060, 66 clinicians

Practice addresses (Care Compare)

255 Union Blvd
Suite 200
Lakewood, CO 80228-1833
Phone (303) 763-5111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35786COMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
OB-GYN Affiliates Obstetrics & Gynecology CurrentSince Jan 15, 2019 Accepting new patients
Intermountain Front Range, Inc. Past Accepting new patients

Locations

7200 S Alton Way
Ste A100
Centennial, CO 80112
Phone (303) 730-2229

255 Union Blvd
Ste 200
Lakewood, CO 80228
Phone (303) 763-5111

Interoperability endpoints

  • Direct secure messaging: michael.johnson.1@8558.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821197476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 UNION BLVD",
            "address_2": "STE 200",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281810",
            "telephone_number": "303-763-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 UNION BLVD",
            "address_2": "STE 200",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281810",
            "telephone_number": "303-763-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHAEL",
        "middle_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CO",
            "license": "35786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01357862",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.