Wallace E Johnson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

200706 Issued in NY

Practice address

800 Ayrault Rd Ste 200
Fairport, NY 14450-8941

Phone

(585) 602-2300

Fax

(585) 425-2750

NPI assigned

Jun 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

State University of New York at Buffalo School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University of RochesterGroup PAC ID 5799699088, 960 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCR / HCR Home Care Chha (Rochester) Home health agency, Rochester, NY, CCN 337257
• Ur Medicine Hospice Hospice, Webster, NY, CCN 331550
• Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285
• F F Thompson Hospital Hospital, Canandaigua, NY, CCN 330074
• Highland Hospital Hospital, Rochester, NY, CCN 330164

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• University of Rochester

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1710226824
  Medicare reassignment Care Compare group NPD
• University of Rochester

  • Community/Retail Pharmacy
  • Rochester, NY
  • NPI 1598476269
  NPD
• University of Rochester

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1821152588
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Highland Hospital of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1972548568
  Care Compare affiliation
• L Woerner Inc

  • Home Health Agency
  • Rochester, NY
  • NPI 1407083033
  Care Compare affiliation
• L Woerner Inc

  • Home Health Agency
  • Rochester, NY
  • NPI 1649285354
  Care Compare affiliation
• The Frederick Ferris Thompson Hospital

  • General Acute Care Hospital
  • Canandaigua, NY
  • NPI 1194776351
  Care Compare affiliation
• University of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1346285657
  Care Compare affiliation
• University of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1669126090
  Care Compare affiliation
• Ur Medicine Home Care, Certified Services, Inc.

  • Community Based Hospice Care Agency
  • Webster, NY
  • NPI 1487715173
  Care Compare affiliation

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1902833619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 AYRAULT RD STE 200",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144508941",
            "telephone_number": "585-602-2300",
            "fax_number": "585-425-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 AYRAULT RD STE 200",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144508941",
            "telephone_number": "585-602-2300",
            "fax_number": "585-425-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "WALLACE",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "200706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01688146",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wjohnson4289@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wjohnson4289@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marielle Jensen-Battaglia, PT, DPT
• John W. Lepore DDS PLLC
• Abigail Castle Baldwin John, DMD
• Safphire Elizabeth Johnson
• Travara Johnson, LPN
• Jonathan Adler, DDS, PLLC
• Jonathan L Donner DC PC
• Kathryn Jones, PHARMD
• April Jordan, RN
• Donnah Marie Jordan, REGISTERED NURSE

• Internal Medicine Physician in Fairport, NY
• Providers in Fairport, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.
• 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.

Verify at the official NPI Registry.