Individual provider Active NPI

Scott Mark Johnson, M.D.

  • Diagnostic Radiology Physician
  • Cleveland, OH
National Provider Identifier
1841557279
Registry record updated Jun 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
10112241-1205 Issued in UT
Practice address
9500 Euclid Ave
HB6
Cleveland, OH 44195
Phone
(216) 444-2200
NPI assigned
Apr 23, 2012
Last updated
Jun 14, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT201188 PA
Diagnostic Radiology Physician 2085R0202X 10112241-1205 UT Primary

Addresses

Primary practice location

9500 Euclid Ave
HB6
Cleveland, OH 44195

Mailing address

9500 Euclid Ave
HB6
Cleveland, OH 44195-0001
Phone (216) 444-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, OH2 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
I20180809005114 UT Practitioner - Diagnostic Radiology 5193962975 Reassigns benefits to 1 organization
I20190805001428 OH Practitioner - Diagnostic Radiology 5193962975 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinic Medical Services CompanyGroup PAC ID 5698674653, 201 clinicians
Wooster Clinic LLCGroup PAC ID 6800708124, 290 clinicians
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

1000 E Washington St
Medina, OH 44256-2170
Phone (330) 721-5117

12300 McCracken Rd
Cleveland, OH 44125-2914
Phone (440) 587-8600

1740 Cleveland Rd
Wooster, OH 44691-2204
Phone (330) 287-4500

2420 Lake Ave
Ashtabula, OH 44004-4954
Phone (440) 997-2262

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-2200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Jun 10, 2018 Accepting new patients
Wooster Clinic, LLC CurrentSince Jun 26, 2019 Accepting new patients
University of Utah Adult Services Current Accepting new patients
Clinic Medical Services Company Diagnostic Radiology CurrentSince Jul 24, 2019 Accepting new patients
Clinic Medical Services Company LLC Diagnostic Radiology CurrentSince Jul 24, 2019 Accepting new patients
Cleveland Clinic Nevada Diagnostic Radiology CurrentSince Oct 6, 2024 Accepting new patients
University of Utah Adult Services Diagnostic Radiology CurrentSince Jun 10, 2018 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Jun 26, 2019 Accepting new patients

Locations

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

9500 Euclid Ave
#6
Cleveland, OH 44195
Phone (216) 444-0617

6100 W Creek Rd
#35
Independence, OH 44131
Phone (216) 642-8165

6100 W Creek Rd
Ste 35
Independence, OH 44131
Phone (212) 986-1666

1740 Cleveland Rd
Wooster, OH 44691
Phone (330) 287-4500

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Organizations & group practices 8

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 5

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": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1841557279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "address_2": "HB6",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-444-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "address_2": "HB6",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44195",
            "telephone_number": "216-444-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SCOTT",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-23",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT201188",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "10112241-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.