Derek B Johnson, MD | |
454 Saint Michaels Dr Ste 200, Santa Fe, NM 87505 | |
(505) 303-5000 | |
Not Available |
Full Name | Derek B Johnson |
---|---|
Gender | Male |
Speciality | General Surgery |
Experience | 26 Years |
Location | 454 Saint Michaels Dr Ste 200, Santa Fe, New Mexico |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1912944661 | NPI | - | NPPES |
34863900 | Medicaid | WI | |
057945003 | Other | WI | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 224930 (Massachusetts) | Secondary |
208600000X | Surgery | 49065 (Wisconsin) | Secondary |
208600000X | Surgery | MD2018-0748 (New Mexico) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Presbyterian Healthcare Services | 9234041708 | 1119 |
Entity Name | Presbyterian Healthcare Services |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1104802354 PECOS PAC ID: 9234041708 Enrollment ID: O20031103000603 |
Entity Name | Roswell Clinic Corp |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649267618 PECOS PAC ID: 9436062759 Enrollment ID: O20031111000799 |
Mailing Address | Practice Location Address |
---|---|
Derek B Johnson, MD Po Box 26666, Phs Provider Enrollment, Albuquerque, NM 87125-6666 Ph: (505) 923-6770 | Derek B Johnson, MD 454 Saint Michaels Dr Ste 200, Santa Fe, NM 87505 Ph: (505) 303-5000 |
Poseidon Spyros Varvitsiotis, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1631 Hospital Dr, Santa Fe, NM 87505 Phone: 505-988-3975 Fax: 505-986-8001 | |
William Edgefield Mitchell Jr., MD Surgery Medicare: Medicare Enrolled Practice Location: 9a Rocky Slope Dr, Santa Fe, NM 87508 Phone: 505-473-3648 | |
Anna M Voltura, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 435 Saint Michaels Dr Ste 104, Santa Fe, NM 87505 Phone: 505-372-1052 Fax: 505-820-3172 | |
John Dirk Wassner, MD Surgery Medicare: Medicare Enrolled Practice Location: 465 Saint Michaels Dr, Suite 110, Santa Fe, NM 87505 Phone: 505-954-8720 | |
Kimberly Ann Moseley, MD Surgery Medicare: Medicare Enrolled Practice Location: 455 Saint Michaels Dr, Santa Fe, NM 87505 Phone: 505-913-3975 | |
Joseph M. Smith Iii, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 490b W Zia Rd, Suite A, Santa Fe, NM 87505 Phone: 505-995-8346 Fax: 505-995-8345 | |
Michael Scott Woods, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 465 Saint Michaels Dr, Suite 110, Santa Fe, NM 87505 Phone: 505-954-8720 |