Dr Kimberly Sue Johnson, MD - Medicare Diagnostic Radiology in 49684 Traverse City, Mi (grand Traverse), MI

Dr Kimberly Sue Johnson, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in 49684 Traverse City, Mi (grand Traverse), Michigan. She went to Michigan State University College Of Human Medicine and graduated in 2009 and has 15 years of diverse experience with area of expertise as Diagnostic Radiology. She is a member of the group practice Grand Traverse Radiologists Pc and her current practice location is 1105 Sixth Street, Suite#100, 49684 Traverse City, Mi (grand Traverse), Michigan. You can reach out to her office (for appointments etc.) via phone at (231) 935-5000.

Dr Kimberly Sue Johnson is licensed to practice in Michigan (license number 4301094869) 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 1467682971.

Contact Information

Dr Kimberly Sue Johnson, MD
1105 Sixth Street, Suite#100,
49684 Traverse City, Mi (grand Traverse), MI 49684
(231) 935-5000
Not Available



Physician's Profile

Full NameDr Kimberly Sue Johnson
GenderFemale
SpecialityDiagnostic Radiology
Experience15 Years
Location1105 Sixth Street, 49684 Traverse City, Mi (grand Traverse), Michigan
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Kimberly Sue Johnson attended and graduated from Michigan State University College Of Human Medicine in 2009
  NPI Data:
  • NPI Number: 1467682971
  • Provider Enumeration Date: 07/17/2009
  • Last Update Date: 05/16/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 4082837604
  • Enrollment ID: I20140528001305

Medical Identifiers

Medical identifiers for Dr Kimberly Sue Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1467682971NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2085R0202XRadiology - Diagnostic Radiology 4301094869 (Michigan)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Munson Medical CenterTraverse city, MIHospital
Munson Healthcare Otsego Memorial HospitalGaylord, MIHospital
Munson Healthcare Cadillac HospitalCadillac, MIHospital
Munson Healthcare Grayling HospitalGrayling, MIHospital
Paul Oliver Memorial HospitalFrankfort, MIHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Grand Traverse Radiologists Pc600286640726

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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 Kimberly Sue Johnson allows following entities to bill medicare on her behalf.
Entity NameHenry Ford Health System
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1134144801
PECOS PAC ID: 0547178311
Enrollment ID: O20031105000139

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Entity NameAdvanced Diagnostic Imaging Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1245299494
PECOS PAC ID: 3779489224
Enrollment ID: O20031208000473

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Entity NameCovenant Medical Center Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1972590412
PECOS PAC ID: 2769387778
Enrollment ID: O20031209000107

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Entity NameGreat Lakes Bay Health Centers
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1871684761
PECOS PAC ID: 2466369046
Enrollment ID: O20040126000171

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Entity NameGrand Traverse Radiologists Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1760404891
PECOS PAC ID: 6002866407
Enrollment ID: O20050124000780

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Entity NameDlp Marquette Physician Practices Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1487902995
PECOS PAC ID: 9931359601
Enrollment ID: O20121016000312

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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 Kimberly Sue 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 AddressPractice Location Address
Dr Kimberly Sue Johnson, MD
Po Box 30516, Dept#9516,
Lansing, MI 48909-7919

Ph: (231) 935-0497
Dr Kimberly Sue Johnson, MD
1105 Sixth Street, Suite#100,
49684 Traverse City, Mi (grand Traverse), MI 49684

Ph: (231) 935-5000

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Radiology Doctors in 49684 Traverse City, Mi (grand Traverse), MI


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