Mr Benjamin Douglas Johnson, PA-C, RT (R) in Fairbanks, AK - Medicare Radiology Practitioner Assistant

Mr Benjamin Douglas Johnson, PA-C, RT (R) is a medicare enrolled "Radiology Practitioner Assistant" physician in Fairbanks, Alaska. His current practice location is 1650 Cowles St, Fairbanks, Alaska. You can reach out to his office (for appointments etc.) via phone at (907) 458-3900.

Mr Benjamin Douglas Johnson is licensed to practice in Alaska (license number 138210) 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 1821516345.

Contact Information

	Mr Benjamin Douglas Johnson, PA-C, RT (R)
	1650 Cowles St, Fairbanks, AK 99701-5907
	(907) 458-3900
	Not Available

Physician's Profile

Full Name	Mr Benjamin Douglas Johnson
Gender	Male
Speciality	Radiology Practitioner Assistant
Location	1650 Cowles St, Fairbanks, Alaska
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1821516345
Provider Enumeration Date: 09/05/2017
Last Update Date: 10/21/2022

Medicare PECOS Information:

PECOS PAC ID: 7214276948
Enrollment ID: I20190225001593

Medical Identifiers

Medical identifiers for Mr Benjamin Douglas Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1821516345	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2085R0202X	Radiology - Diagnostic Radiology	138210 (Alaska)	Secondary
207X00000X	Orthopaedic Surgery	1760938021 (Alaska)	Secondary
2085R0203X	Radiology - Therapeutic Radiology	138210 (Alaska)	Secondary
243U00000X	Radiology Practitioner Assistant	138210 (Alaska)	Primary

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. Mr Benjamin Douglas 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
Mr Benjamin Douglas Johnson, PA-C, RT (R) 4311 11th Ave Ne Ste 200, Seattle, WA 98105-6367 Ph: () -	Mr Benjamin Douglas Johnson, PA-C, RT (R) 1650 Cowles St, Fairbanks, AK 99701-5907 Ph: (907) 458-3900

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Mr Benjamin Douglas Johnson, PA-C, RT (R) - Medicare Radiology Practitioner Assistant in Fairbanks, AK