Dr Shelly Johnson, MD is a medicare enrolled "Internal Medicine" physician in South Kingstown, Rhode Island. She went to Stanford University School Of Medicine and graduated in 1989 and has 35 years of diverse experience with area of expertise as Internal Medicine. She is a member of the group practice Coastal Medical Physicians Inc and her current practice location is
59 S County Commons Way Fl H32, South Kingstown, Rhode Island. You can reach out to her office (for appointments etc.) via phone at
(401) 783-0084.
Dr Shelly Johnson is licensed to practice in Rhode Island (license number MD08863) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1528055191.
Physician's Profile
| Full Name | Dr Shelly Johnson |
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| Gender | Female |
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| Speciality | Internal Medicine |
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| Experience | 35 Years |
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| Location | 59 S County Commons Way Fl H32, South Kingstown, Rhode Island |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Shelly Johnson attended and graduated from Stanford University School Of Medicine in 1989
NPI Data:
- NPI Number: 1528055191
- Provider Enumeration Date: 09/29/2005
- Last Update Date: 04/02/2024
Medicare PECOS Information:
- PECOS PAC ID: 4183600406
- Enrollment ID: I20040628000640
Medical Identifiers
Medical identifiers for Dr Shelly Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1528055191 | NPI | - | NPPES |
| 007056629 | Other | RI | MEDICARE |
| 7004665 | Medicaid | RI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | MD08863 (Rhode Island) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Coastal Medical Physicians Inc | 0345658316 | 150 |
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 Shelly Johnson allows following entities to bill medicare on her behalf.
| Entity Name | Coastal Medical Physicians Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1780273540
PECOS PAC ID: 0345658316
Enrollment ID: O20210427001413 |
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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 Shelly 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 Shelly Johnson, MD
10 Davol Sq, Suite 400,
Providence, RI 02903-4754
Ph: (401) 421-4000 | Dr Shelly Johnson, MD
59 S County Commons Way Fl H32,
South Kingstown, RI 02879-8270
Ph: (401) 783-0084 |
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