Matthew Tyler Johnson, LICSW in Edina, MN - Medicare Counselor Provider

Matthew Tyler Johnson, LICSW is a medicare enrolled "Counselor - Mental Health" provider in Edina, Minnesota. His current practice location is 4820 77th St W Ste 117, Edina, Minnesota. You can reach out to his office (for appointments etc.) via phone at (612) 208-2762.

Matthew Tyler Johnson is licensed to practice in Minnesota (license number 27484) 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 1487227229.

Contact Information

	Matthew Tyler Johnson, LICSW
	4820 77th St W Ste 117, Edina, MN 55435-4809
	(612) 208-2762
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Matthew Tyler Johnson
Gender	Male
Speciality	Counselor - Mental Health
Location	4820 77th St W Ste 117, Edina, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1487227229
Provider Enumeration Date: 07/20/2021
Last Update Date: 01/16/2025

Medicare PECOS Information:

PECOS PAC ID: 6800280975
Enrollment ID: I20220307001500

Medical Identifiers

Medical identifiers for Matthew Tyler Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1487227229	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	27484 (Minnesota)	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. Matthew Tyler Johnson allows following entities to bill medicare on his behalf.

Entity Name	Canvas Health Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1922051325 PECOS PAC ID: 8729073978 Enrollment ID: O20040416001178

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. Matthew Tyler 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
Matthew Tyler Johnson, LICSW 800 Prairie Center Dr Ste 210, Eden Prairie, MN 55344-7306 Ph: (612) 888-0544	Matthew Tyler Johnson, LICSW 4820 77th St W Ste 117, Edina, MN 55435-4809 Ph: (612) 208-2762

Reviews and Comments

Counselor in Edina, MN

Stephen Wayne Peterson, LPCC Counselor Medicare: Medicare Enrolled Practice Location: 7400 Metro Blvd Ste 220, Edina, MN 55439 Phone: 952-220-7164
Melissa Derby-sessions, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 7400 Metro Blvd, Edina, MN 55439 Phone: 612-564-2271
Elizabeth Kaye Dumke, MS, LPCC, ATR Counselor Medicare: Medicare Enrolled Practice Location: 4820 W 77th St Ste 130, Edina, MN 55435 Phone: 651-313-8080 Fax: 651-925-0610
John Rundquist, Counselor Medicare: Not Enrolled in Medicare Practice Location: 7250 Metro Blvd Ste 100, Edina, MN 55439 Phone: 612-374-0506 Fax: 651-323-2051
Jille Neiman, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 7602 York Ave S Apt 7115, Edina, MN 55435 Phone: 612-251-8320
Mr. Kyle J Slawson, LPCC, LADC Counselor Medicare: Medicare Enrolled Practice Location: 7301 Ohms Ln Ste 450, Edina, MN 55439 Phone: 952-831-2000
Tember Graves, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3400 W 66th St Ste 400, Edina, MN 55435 Phone: 952-924-5901

Matthew Tyler Johnson, LICSW - Medicare Counselor in Edina, MN