Eric Robert Johnson, MD is a medicare enrolled "Surgery" physician in Brockport, New York. His current practice location is
59 West Ave, Brockport, New York. You can reach out to his office (for appointments etc.) via phone at
(585) 637-6120.
Eric Robert Johnson is licensed to practice in New York (license number 180005) 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 1770546277.
Physician's Profile
| Full Name | Eric Robert Johnson |
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| Gender | Male |
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| Speciality | Surgery |
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| Location | 59 West Ave, Brockport, New York |
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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: 1770546277
- Provider Enumeration Date: 04/07/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 7214925833
- Enrollment ID: I20040503001580
Medical Identifiers
Medical identifiers for Eric Robert Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1770546277 | NPI | - | NPPES |
| 01414933 | Medicaid | NY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208600000X | Surgery | 180005 (New York) | 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. Eric Robert Johnson allows following entities to bill medicare on his behalf.
| Entity Name | Eastern Niagara Hospital Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1063400539
PECOS PAC ID: 1254389620
Enrollment ID: O20050112000475 |
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| Entity Name | Kenmore Immediate Care Corp Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1124528724
PECOS PAC ID: 5395078224
Enrollment ID: O20190610000542 |
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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. Eric Robert 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 |
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Eric Robert Johnson, MD
59 West Ave,
Brockport, NY 14420
Ph: (585) 637-6120 | Eric Robert Johnson, MD
59 West Ave,
Brockport, NY 14420
Ph: (585) 637-6120 |
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