Active NPI
Mary Johnson, NP
- Adult Health Nurse Practitioner
- New York, NY
National Provider Identifier
1841861168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 310464
- Practice address
- 228 Park Ave S Ste 16389
New York, NY 10003-0103 - Phone
- (646) 876-8455
- NPI assigned
- Jul 7, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 310464 | NY | Primary |
| Adult Health Nurse Practitioner | 363LA2200X | NP500225972 | DC | |
| Adult Health Nurse Practitioner | 363LA2200X | 4704439802 | MI | |
| Adult Health Nurse Practitioner | 363LA2200X | 0024194096 | VA | |
| Adult Health Nurse Practitioner | 363LA2200X | RN10028361 | MA | |
| Adult Health Nurse Practitioner | 363LA2200X | R275385 | MD | |
| Adult Health Nurse Practitioner | 363LA2200X | TPAN35453 | FL |
Addresses
Primary practice location
228 Park Ave S Ste 16389
New York, NY 10003-0103
Mailing address
169 Madison Ave Ste 381114
New York, NY 10016-5101
Phone (646) 876-8455
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 96.62 of 100
- Quality
- 74.51
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP500225972 | DC | MD | Adult Health Nurse Practitioner |
| TPAN35453 | FL | MD | Adult Health Nurse Practitioner |
| RN10028361 | MA | MD | Adult Health Nurse Practitioner |
| R275385 | MD | MD | Adult Health Nurse Practitioner |
| 4704439802 | MI | MD | Adult Health Nurse Practitioner |
| 310464 | NY | MD | Adult Health Nurse Practitioner |
| 0024194096 | VA | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rochester General Hospital | Current | Accepting new patients | |
| The Unity Hospital of Rochester | Current | Accepting new patients | |
| Rochester General Hospital | Current | Accepting new patients | |
| Clifton Springs Sanitarium Co | Current | Accepting new patients | |
| Western New York Medical Practice PC | Current | Accepting new patients | |
| Western New York Medical Practice P.C. | Current | Accepting new patients | |
| The Unity Hospital of Rochester | Current | Accepting new patients |
Locations
2 Coulter Rd
Clifton Springs, NY 14432
Phone (315) 462-1472
224 Alexander St
Rochester, NY 14607
Phone (585) 922-7770
1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122
100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553
Interoperability endpoints
- mary.johnson.1@22307.direct.athenahealth.com
Organizations & group practices 7
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.
-
- General Acute Care Hospital
- Clifton Springs, NY
- NPI 1366505463
-
- Family Medicine Physician
- Rochester, NY
- NPI 1356412712
-
- General Acute Care Hospital
- Rochester, NY
- NPI 1760421713
-
- Family Medicine Physician
- Rochester, NY
- NPI 1063790608
-
- General Acute Care Hospital
- Rochester, NY
- NPI 1255360517
-
- General Acute Care Hospital
- Rochester, NY
- NPI 1457395766
-
- Obstetrics & Gynecology Physician
- Warsaw, NY
- NPI 1306214689
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773792000000",
"number": "1841861168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "169 MADISON AVE STE 381114",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100165101",
"telephone_number": "646-876-8455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "228 PARK AVE S STE 16389",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100030103",
"telephone_number": "646-876-8455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MARY",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-07",
"last_updated": "2026-03-18",
"certification_date": "2026-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "310464",
"primary": true
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "DC",
"license": "NP500225972",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MI",
"license": "4704439802",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "VA",
"license": "0024194096",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MA",
"license": "RN10028361",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MD",
"license": "R275385",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "FL",
"license": "TPAN35453",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; 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.