Individual provider Active NPI

Michael F Johnstone, MD

  • Family Medicine Physician
  • Brown Deer, WI
National Provider Identifier
1982665394
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25308 Issued in WI
Practice address
9233 N Green Bay Rd
Brown Deer, WI 53209-1103
Phone
(414) 270-8150
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25308 WI Primary

Addresses

Primary practice location

9233 N Green Bay Rd
Brown Deer, WI 53209-1103

Mailing address

4425 N Port Washington Rd
Attn: Clinic Credentialing
Glendale, WI 53212-1082
Phone (414) 270-8150

Other identifiers 1

IdentifierTypeStateIssuer
30561400MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20080128000105 WI Practitioner - Family Practice 0547342743 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25308WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary's Hospital Milwaukee, Inc Family Medicine Current Accepting new patients
Columbia St. Mary's Hospital Milwaukee Inc CurrentSince Jun 20, 2018 Accepting new patients
Columbia St. Mary's Hospital Milwaukee, Inc CurrentSince Jun 20, 2018 Accepting new patients
Outreach Community Health Centers, Inc. Past Accepting new patients

Locations

N112W15415 Mequon Rd
Germantown, WI 53022
Phone (262) 250-7800

4425 N Port Washington Rd
Glendale, WI 53212
Phone (414) 326-2218

6900 N Port Washington Rd
Glendale, WI 53217
Phone (414) 270-8100

9252 N Green Bay Rd
Fl 2
Milwaukee, WI 53209
Phone (414) 270-8150

1317 W Grand Ave
Prt Washingtn, WI 53074
Phone (262) 268-6998

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1982665394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 N PORT WASHINGTON RD",
            "address_2": "ATTN: CLINIC CREDENTIALING",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121082",
            "telephone_number": "414-270-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9233 N GREEN BAY RD",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532091103",
            "telephone_number": "414-270-8150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTONE",
        "first_name": "MICHAEL",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "25308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30561400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brown Deer, WI

Sources for this page

Verify at the official NPI Registry.