Active NPI
Khai-El Johnson, M.D.
- Family Medicine Physician
- Dorchester, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD047107
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110117208A | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, MA, VT, ME, NH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 5
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
| License | State | Type | Specialty |
|---|---|---|---|
| MD047107 | DC | MD | Family Medicine Physician |
| 285614 | MA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Codman Square Health Center Inc | Current | Accepting new patients | |
| Medical Faculty Associates, Inc | Current | 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
- 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.
-
- Anesthesiology Physician
- Washington, DC
- NPI 1417990581
-
- Community Health Clinic/Center
- Dorchester Center, MA
- NPI 1396808309
-
- Addiction Medicine (Internal Medicine) Physician
- West Springfield, MA
- NPI 1770816506
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.