Active NPI
David Johnson
- Physician Assistant
- Freeport, NY
National Provider Identifier
1902115595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 004565-1
- Practice address
- 939 S Long Beach Ave
Freeport, NY 11520-6306 - Phone
- (516) 547-2357
- NPI assigned
- Sep 29, 2010
- Last updated
- Sep 29, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 004565-1 | NY | Primary |
Addresses
Primary practice location
939 S Long Beach Ave
Freeport, NY 11520-6306
Mailing address
939 S Long Beach Ave
Freeport, NY 11520-6306
Phone (516) 547-2357
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 Compare- Specialty
- Physician Assistant
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3430 Sunrise Hwy
Wantagh, NY 11793-4069
Phone (516) 900-1600
900 Hillside Ave
New Hyde Park, NY 11040-2522
Phone (516) 519-8400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004565 | NY | MD | Acupuncturist |
| 004565-1 | NY | MD | Speech-Language Pathologist |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Urgent Care Clinic/Center
- New Hyde Park, NY
- NPI 1952652281
-
- Urgent Care Clinic/Center
- Wantagh, NY
- NPI 1184067936
-
dba Nao Medical
- Family Medicine Physician
- Mineola, NY
- NPI 1770813792
-
- Internal Medicine Physician
- New Hyde Park, NY
- NPI 1700922150
-
dba Nao Medical
- Urgent Care Clinic/Center
- Mineola, NY
- NPI 1336426667
-
- Urgent Care Clinic/Center
- Centereach, NY
- NPI 1962181925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285718400000",
"number": "1902115595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "939 S LONG BEACH AVE",
"city": "FREEPORT",
"state": "NY",
"postal_code": "115206306",
"telephone_number": "516-547-2357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "939 S LONG BEACH AVE",
"city": "FREEPORT",
"state": "NY",
"postal_code": "115206306",
"telephone_number": "516-547-2357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "DAVID",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-29",
"last_updated": "2010-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "004565-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Freeport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2010; 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.