Active NPI
Mark Edmund Johnston, MD FRCSC
- Ophthalmology Physician
- Omaha, NE
National Provider Identifier
1851398168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 20412
- Practice address
- 13330 N 74TH St
Omaha, NE 68122-1919 - Phone
- (402) 639-3250
- Fax
- (402) 387-7967
- NPI assigned
- Jun 30, 2005
- Last updated
- Mar 6, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 31743 | IA | |
| Ophthalmology Physician | 207W00000X | 20412 | NE | Primary |
Addresses
Primary practice location
13330 N 74TH St
Omaha, NE 68122-1919
Mailing address
13330 N 74TH St
Omaha, NE 68122-1919
Phone (026) 393-2504
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120223000981 | NE | Practitioner - Ophthalmology | 3779552385 | Practice locations: Omaha, NE |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31743 | IA | MD | Ophthalmology Physician |
| 20412 | NE | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678060800000",
"number": "1851398168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13330 N 74TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681221919",
"telephone_number": "026-393-2504",
"fax_number": "402-397-7967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13330 N 74TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681221919",
"telephone_number": "402-639-3250",
"fax_number": "402-387-7967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "MARK",
"middle_name": "EDMUND",
"name_prefix": "Dr.",
"credential": "MD FRCSC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-30",
"last_updated": "2023-03-06",
"certification_date": "2023-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IA",
"license": "31743",
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NE",
"license": "20412",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.