Dr David R Johnson, MD is a medicare enrolled "Family Medicine" physician in Indpls, Indiana. His current practice location is
2001 W 86th St., St. Vincent Emergency Physicians, Inc, Indpls, Indiana. You can reach out to his office (for appointments etc.) via phone at
(317) 802-3140.
Dr David R Johnson is licensed to practice in Indiana (license number 01037139) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1043293244.
Physician's Profile
Full Name | Dr David R Johnson |
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Gender | Male |
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Speciality | Family Medicine |
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Location | 2001 W 86th St., Indpls, Indiana |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1043293244
- Provider Enumeration Date: 11/22/2005
- Last Update Date: 01/22/2009
Medicare PECOS Information:
- PECOS PAC ID: 3274599337
- Enrollment ID: I20041209000737
Medical Identifiers
Medical identifiers for Dr David R Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1043293244 | NPI | - | NPPES |
200013750 | Medicaid | IN | |
200013730 | Medicaid | IN | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 01037139A (Indiana) | Secondary |
207P00000X | Emergency Medicine | 01037139 (Indiana) | Secondary |
207Q00000X | Family Medicine | 01037139 (Indiana) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr David R Johnson allows following entities to bill medicare on his behalf.
Entity Name | St. Vincent Emergency Physicians, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1306891700 PECOS PAC ID: 1759363450 Enrollment ID: O20040720000734 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr David R Johnson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr David R Johnson, MD 4685 Reliable Pkwy, St Vincent Emergency Physicians, Inc, Chicago, IL 60686-0046 Ph: (317) 802-3140 | Dr David R Johnson, MD 2001 W 86th St., St. Vincent Emergency Physicians, Inc, Indpls, IN 46260-1902 Ph: (317) 802-3140 |
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