Miss Velisa Marie Johnson, PHD is a medicare enrolled "Clinical Neuropsychologist" provider in Grand Rapids, Michigan. Her current practice location is
35 Michigan St Ne Ste 5201, Grand Rapids, Michigan. You can reach out to her office (for appointments etc.) via phone at
(616) 267-2830.
Miss Velisa Marie Johnson is licensed to practice in Michigan (license number 6301016552) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1184892952.
Healthcare Provider's Profile
Full Name | Miss Velisa Marie Johnson |
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Gender | Female |
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Speciality | Clinical Neuropsychologist |
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Location | 35 Michigan St Ne Ste 5201, Grand Rapids, Michigan |
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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: 1184892952
- Provider Enumeration Date: 02/14/2008
- Last Update Date: 02/17/2021
Medicare PECOS Information:
- PECOS PAC ID: 0648542944
- Enrollment ID: I20170822001300
Medical Identifiers
Medical identifiers for Miss Velisa Marie Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1184892952 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103T00000X | Psychologist | (* (Not Available)) | Secondary |
103G00000X | Clinical Neuropsychologist | 6301016552 (Michigan) | 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. Miss Velisa Marie Johnson allows following entities to bill medicare on her behalf.
Entity Name | Spectrum Health Primary Care Partners |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1235188673 PECOS PAC ID: 4587568647 Enrollment ID: O20031121000091 |
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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. Miss Velisa Marie 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 |
Miss Velisa Marie Johnson, PHD 100 Michigan St Ne # Mc845, Grand Rapids, MI 49503-2560 Ph: (616) 486-6790 | Miss Velisa Marie Johnson, PHD 35 Michigan St Ne Ste 5201, Grand Rapids, MI 49503-2514 Ph: (616) 267-2830 |
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