Individual provider Active NPI

Lindsey N Johnson, DO

  • Dermatology Physician
  • Glendale, AZ
National Provider Identifier
1912696550
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
011530 Issued in AZ
Practice address
11851 N 51St Ave Ste E130
Glendale, AZ 85304-2843
Phone
(623) 299-9540
NPI assigned
May 1, 2023
Last updated
Apr 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 011530 AZ Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

11851 N 51St Ave Ste E130
Glendale, AZ 85304-2843

Mailing address

11851 N 51St Ave Ste E130
Glendale, AZ 85304-2843
Phone (623) 299-9540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20250422002926 AZ Practitioner - Osteopathic Manipulative Medicine 7012432040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Omni Dermatology IncorporatedGroup PAC ID 5698846558, 13 clinicians

Practice addresses (Care Compare)

4801 E McDowell Rd
Suite 150
Phoenix, AZ 85008-7725
Phone (602) 954-3919

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions24
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Dermatology Incorporated Dermatology CurrentSince Feb 9, 2025 Accepting new patients

Locations

11851 N 51st Ave
Ste E130
Glendale, AZ 85304
Phone (623) 253-9814

10204 W Happy Valley Pkwy
Ste 165
Peoria, AZ 85383
Phone (623) 323-6777

4801 E McDowell Rd
Ste 150
Phoenix, AZ 85008
Phone (602) 954-3919

4801 E McDowell Rd
Ste 150
Phoenix, AZ 85008

4840 E Indian School Rd
Ste 102
Phoenix, AZ 85018
Phone (602) 954-3919

9305 W Thomas Rd
Ste 405
Phoenix, AZ 85037
Phone (623) 303-8800

4515 S McClintock Dr
Ste 101
Tempe, AZ 85282
Phone (480) 775-8460

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6619/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1912696550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11851 N 51ST AVE STE E130",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853042843",
            "telephone_number": "623-299-9540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11851 N 51ST AVE STE E130",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853042843",
            "telephone_number": "623-299-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LINDSEY",
        "middle_name": "N",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-01",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "011530",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.