Kenneth Ian Johnson, MD in Port St Lucie, FL

Kenneth Ian Johnson, MD is a medicare enrolled "Family Medicine" physician in Port St Lucie, Florida. His current practice location is 1700 Se Hillmoor Dr Ste 501, Port St Lucie, Florida. You can reach out to his office (for appointments etc.) via phone at (772) 212-7049.

Kenneth Ian Johnson is licensed to practice in Florida (license number ME73635) 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 1457349508.

Contact Information

	Kenneth Ian Johnson, MD
	1700 Se Hillmoor Dr Ste 501, Port St Lucie, FL 34952
	(772) 212-7049
	(772) 212-7059

Map and Direction

Physician's Profile

Full Name	Kenneth Ian Johnson
Gender	Male
Speciality	Family Medicine
Location	1700 Se Hillmoor Dr Ste 501, Port St Lucie, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1457349508
Provider Enumeration Date: 10/12/2005
Last Update Date: 06/28/2018

Medicare PECOS Information:

PECOS PAC ID: 5294863411
Enrollment ID: I20100510000397

Medical Identifiers

Medical identifiers for Kenneth Ian Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1457349508	NPI	-	NPPES
80193338	Other	FL	RAILROAD
ME73635	Other	FL	VHN
578869751	Other	FL	TRICARE
BCBS	Other	FL	35407
ME73635	Other	FL	DCWO
ME73635	Other	FL	UNITED BENEFITS
258874900	Medicaid	FL

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	ME73635 (Florida)	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. Kenneth Ian Johnson allows following entities to bill medicare on his behalf.

Entity Name	Pcc Medical Holdings Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1174167993 PECOS PAC ID: 0446679468 Enrollment ID: O20200924001757

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. Kenneth Ian 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
Kenneth Ian Johnson, MD 14690 Spring Hill Dr Ste 305, Spring Hill, FL 34609-8102 Ph: (352) 277-5348	Kenneth Ian Johnson, MD 1700 Se Hillmoor Dr Ste 501, Port St Lucie, FL 34952 Ph: (772) 212-7049

Reviews and Comments

Family Medicine Doctors in Port St Lucie, FL

Dr. Adan Fernando Hernandez, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1800 Se Tiffany Ave, Port St Lucie, FL 34952 Phone: 772-237-0813 Fax: 772-238-2004
Isabel Teresa Casariego Cruz, M.D Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1651 Se Tiffany Ave, Port St Lucie, FL 34952 Phone: 772-398-1800 Fax: 772-398-1828
Evelyn Rodriguez, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1700 Se Hillmoor Dr, Port St Lucie, FL 34952 Phone: 772-335-9600
Dr. David A. Hurst, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 537 Nw Lake Whitney Pl, Port St Lucie, FL 34986 Phone: 772-335-9600
Dr. Pablo H Tirado, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1700 Se Hillmoor Dr, Suite 200, Port St Lucie, FL 34952 Phone: 772-335-9600 Fax: 772-398-7951
Dr. Konstantin Alekseyenko, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987 Phone: 772-344-3811 Fax: 772-344-3890
Paula Andrea Michelle Crawford-harris, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 293 Nw Peacock Blvd Ste 101-104, Port St Lucie, FL 34986 Phone: 772-335-9600 Fax: 772-879-4478

Kenneth Ian Johnson, MD - Medicare Family Medicine in Port St Lucie, FL