Individual provider Active NPI

Khai-El Johnson, M.D.

  • Family Medicine Physician
  • Dorchester, MA
National Provider Identifier
1831553080
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD047107 Issued in DC
Practice address
637 Washington St
Dorchester, MA 02124-3510
Phone
(617) 825-9660
Fax
(617) 288-7898
NPI assigned
Apr 13, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 285614 MA
Family Medicine Physician 207Q00000X MD047107 DC Primary

Addresses

Primary practice location

637 Washington St
Dorchester, MA 02124-3510

Mailing address

637 Washington St
Dorchester, MA 02124-3510
Phone (617) 825-9660

Other practice location 1

2902 Porter St NW
Washington, DC 20008-3286
Phone (202) 525-5287

Other identifiers 1

IdentifierTypeStateIssuer
110117208AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MA, VT, ME, NH5 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 5

Enrollment IDStateProvider typePAC IDDetails
I20190705000157 DC Practitioner - Family Practice 6709171341 Reassigns benefits to 1 organization
I20201127000114 MA Practitioner - Family Practice 6709171341
I20231017002676 VT Practitioner - Family Practice 6709171341
I20240911002255 ME Practitioner - Family Practice 6709171341
I20240925001072 NH Practitioner - Family Practice 6709171341

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Meharry Medical College School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

130 Jenness Hill Rd
PO Box 248
Bristol, NH 03222-0248

637 Washington St
Dorchester, MA 02124-3510

PO Box
Suite 1110
Watertown, MA 02471

PO Box
Suite 1110
Watertown, MA 02471-1110

PO Box
Suite 5518
Hanover, NH 03755-5518

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD047107DCMDFamily Medicine Physician
285614MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Codman Square Health Center Inc CurrentSince Oct 1, 2020 Accepting new patients
Medical Faculty Associates, Inc CurrentSince Jun 7, 2019 Accepting new patients
Total Wellness Centers, LLC Past Accepting new patients

Locations

2021 K St NW
Ste 408
Washington, DC 20006
Phone (202) 223-1024

2902 Porter St NW
Washington, DC 20008
Phone (202) 525-5287

900 23rd St NW
Washington, DC 20037
Phone (202) 715-4750

637 Washington St
Dorchestr Ctr, MA 02124
Phone (617) 822-8211

Interoperability endpoints

  • Direct secure messaging: kjohnson94317@direct.bmc.masshiway.net

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": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1831553080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 WASHINGTON ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021243510",
            "telephone_number": "617-825-9660",
            "fax_number": "617-288-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 WASHINGTON ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021243510",
            "telephone_number": "617-825-9660",
            "fax_number": "617-288-7898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2902 Porter St NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200083286",
            "country_code": "US",
            "telephone_number": "202-525-5287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KHAI-EL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "285614",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD047107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110117208A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

Verify at the official NPI Registry.