Individual provider Active NPI

John Michael Johnson, OD

  • Optometrist
  • Hilton Head Island, SC
National Provider Identifier
1992881239
Registry record updated Jul 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1382 Issued in SC
Practice address
224 Pembroke Drive
Hilton Head Island, SC 29926
Phone
(843) 689-3937
Fax
(843) 689-5550
NPI assigned
Oct 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1382 SC Primary

Addresses

Primary practice location

224 Pembroke Drive
Hilton Head Island, SC 29926

Mailing address

PO Box 22899
Hilton Head Island, SC 29925
Phone (843) 689-3937

Other identifiers 1

IdentifierTypeStateIssuer
D13821MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20050923000127 SC Practitioner - Optometry 4981638426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bishop Eye Associates, PAGroup PAC ID 5395845184, 6 clinicians

Practice addresses (Care Compare)

224 Pembroke Dr
Hilton Head Island, SC 29926-6200
Phone (843) 689-3937

Merit-based Incentive Payment System (MIPS)

Final score
92.74 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
75.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bishop Eye Associates, PA CurrentSince Jul 1, 2007 Accepting new patients
Palmetto Eye Specialists, P.a. Optometrist PastSince Jan 1, 2006 Accepting new patients
Sungate Medical Group LLC Optometrist Past Accepting new patients

Locations

300 New River Pkwy
Ste 31
Hardeeville, SC 29927
Phone (843) 208-3937

224 Pembroke Dr
Hilton Head Island, SC 29926
Phone (843) 689-3737

Organizations & group practices 3

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": "1162166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311897600000",
    "number": "1992881239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22899",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "29925",
            "telephone_number": "843-689-3937",
            "fax_number": "843-689-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 PEMBROKE DRIVE",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "29926",
            "telephone_number": "843-689-3937",
            "fax_number": "843-689-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-30",
        "last_updated": "2011-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D13821",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilton Head Island, SC

Sources for this page

Verify at the official NPI Registry.