Individual provider Active NPI

Michael Isaac Johnson, DPM

  • Foot Surgery Podiatrist
  • New York, NY
National Provider Identifier
1902366883
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
N00728501 Issued in NY
Practice address
295 Madison Ave FL 4
New York, NY 10017-7716
Phone
(212) 682-6620
NPI assigned
Mar 25, 2019
Last updated
Jun 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X N00728501 NY Primary

Addresses

Primary practice location

295 Madison Ave FL 4
New York, NY 10017-7716

Mailing address

2742 Brown St FL 2
Brooklyn, NY 11235-1612
Phone (716) 495-2522

Other practice location 1

101 Greenwich St Fl 15
New York, NY 10006-1886
Phone (212) 374-0150

Other practice location 2

336 W Passaic St Ste 311
Rochelle Park, NJ 07662-3027
Phone (646) 306-5340

Other names 1

  • Michael Isaac Johnson Former name

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250923003740 NY Practitioner - Podiatry 2860997640 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Medical and Diagnostic Center IncGroup PAC ID 9436041217, 14 clinicians

Practice addresses (Care Compare)

8046 Kew Gardens Rd
Kew Gardens, NY 11415-1154
Phone (718) 261-1000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007285NYMDNutritionist
N00728501NYMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
M Isaac Johnson DPM PLLC CurrentSince Oct 5, 2025 Accepting new patients
Sammyding LLC CurrentSince Nov 5, 2023 Accepting new patients
New York Medical & Diagnostic Center Inc CurrentSince Aug 1, 2025 Accepting new patients
Jordan B Smith M D P C PastSince Aug 4, 2024 Accepting new patients

Locations

8046 Kew Gardens Rd
Kew Gardens, NY 11415
Phone (718) 261-1000

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1902366883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2742 BROWN ST FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112351612",
            "telephone_number": "716-495-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 MADISON AVE FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100177716",
            "telephone_number": "212-682-6620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Greenwich St Fl 15",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100061886",
            "country_code": "US",
            "telephone_number": "212-374-0150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "336 W Passaic St Ste 311",
            "address_purpose": "LOCATION",
            "city": "Rochelle Park",
            "state": "NJ",
            "postal_code": "076623027",
            "country_code": "US",
            "telephone_number": "646-306-5340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHAEL",
        "middle_name": "ISAAC",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-25",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "N00728501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "JOHNSON",
            "middle_name": "ISAAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.