Individual provider Active NPI

Leonard B Johnson, MD

  • Infectious Disease Physician
  • Grosse Pointe Woods, MI
National Provider Identifier
1982697645
Registry record updated May 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
4301062126 Issued in MI
Practice address
19251 Mack Ave
333
Grosse Pointe Woods, MI 48236-2893
Phone
(313) 343-7280
Fax
(313) 343-7921
NPI assigned
Aug 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 4301062126 MI Primary

Addresses

Primary practice location

19251 Mack Ave
333
Grosse Pointe Woods, MI 48236-2893

Mailing address

43800 Garfield Rd
Clinton Township, MI 48038-1136
Phone (313) 343-7280

Other identifiers 1

IdentifierTypeStateIssuer
3499036MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20100429000550 MI Practitioner - Infectious DiseasePractitioner - Internal Medicine 0143357749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health St. John HospitalGroup PAC ID 3173424082, 332 clinicians

Practice addresses (Care Compare)

19251 Mack Ave
Suite 333
Grosse Pointe Woods, MI 48236-2898
Phone (313) 343-7280

22101 Moross Rd
Detroit, MI 48236-2148
Phone (586) 753-0011

Hospital & facility affiliations

  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301062126MIMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital CurrentSince Apr 1, 2002 Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Apr 1, 2002 Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
Pathology Specialists of Southeast Michigan PC Current Accepting new patients
St. John Hospital Past Accepting new patients

Locations

43800 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 228-4635

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

19251 Mack Ave
Ste 333
Grosse Pointe Woods, MI 48236
Phone (313) 343-7280

Interoperability endpoints

  • Direct secure messaging: ljohnson1133534@direct.hfhs.org

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242000000000",
    "number": "1982697645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43800 GARFIELD RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381136",
            "telephone_number": "313-343-7280",
            "fax_number": "313-343-7921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19251 MACK AVE",
            "address_2": "333",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362893",
            "telephone_number": "313-343-7280",
            "fax_number": "313-343-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LEONARD",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2009-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MI",
            "license": "4301062126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3499036",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Woods, MI

Sources for this page

Verify at the official NPI Registry.