Dr Kenneth Eugene Johnson Jr, DO is a medicare enrolled "Obstetrics & Gynecology" physician in Davie, Florida. His current practice location is
3200 S University Dr, Davie, Florida. You can reach out to his office (for appointments etc.) via phone at
(954) 262-1142.
Dr Kenneth Eugene Johnson Jr is licensed to practice in Florida (license number OS0007290) 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 1760597009.
Physician's Profile
| Full Name | Dr Kenneth Eugene Johnson Jr |
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| Gender | Male |
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| Speciality | Obstetrics & Gynecology |
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| Location | 3200 S University Dr, Davie, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1760597009
- Provider Enumeration Date: 08/19/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 3577739077
- Enrollment ID: I20120105000121
Medical Identifiers
Medical identifiers for Dr Kenneth Eugene Johnson Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1760597009 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207V00000X | Obstetrics & Gynecology | OS0007290 (Florida) | 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 Kenneth Eugene Johnson Jr allows following entities to bill medicare on his behalf.
| Entity Name | Nova Southeastern University Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1700924511
PECOS PAC ID: 4486568896
Enrollment ID: O20031118000987 |
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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 Kenneth Eugene Johnson Jr 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 Kenneth Eugene Johnson Jr, DO
6100 Sw 20th St,
Plantation, FL 33317-5226
Ph: (954) 584-1448 | Dr Kenneth Eugene Johnson Jr, DO
3200 S University Dr,
Davie, FL 33328-2018
Ph: (954) 262-1142 |
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