Dr Tad Mark Johnson, MD is a medicare enrolled "Allergy & Immunology - Allergy" physician in Janesville, Wisconsin. His current practice location is
3524 E Milwaukee St, Janesville, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(608) 756-7100.
Dr Tad Mark Johnson is licensed to practice in Wisconsin (license number 25307) 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 1659339919.
Physician's Profile
| Full Name | Dr Tad Mark Johnson |
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| Gender | Male |
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| Speciality | Allergy & Immunology - Allergy |
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| Location | 3524 E Milwaukee St, Janesville, Wisconsin |
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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: 1659339919
- Provider Enumeration Date: 05/03/2006
- Last Update Date: 09/06/2012
Medicare PECOS Information:
- PECOS PAC ID: 8022290642
- Enrollment ID: I20110303000174
Medical Identifiers
Medical identifiers for Dr Tad Mark Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1659339919 | NPI | - | NPPES |
| JOHNSTAD | Other | WI | MERCYCARE INSURANCE |
| 1659339919 | Other | WI | BCBSWI |
| 1659339919 | Medicaid | WI | |
| 30661900 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207KA0200X | Allergy & Immunology - Allergy | 25307 (Wisconsin) | 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 Tad Mark Johnson allows following entities to bill medicare on his behalf.
| Entity Name | Mercy Health System Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1598718603
PECOS PAC ID: 7416860440
Enrollment ID: O20031113000164 |
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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 Tad Mark 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 Tad Mark Johnson, MD
3524 E Milwaukee St,
Janesville, WI 53546-1626
Ph: (608) 756-7100 | Dr Tad Mark Johnson, MD
3524 E Milwaukee St,
Janesville, WI 53546-1626
Ph: (608) 756-7100 |
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