| Andrew J Johnson, DPM | |
|
1245 S Washington Ave, Detroit Lakes, MN 56501-3905 | |
| (218) 846-2000 | |
| (218) 846-2114 |
| Full Name | Andrew J Johnson |
|---|---|
| Gender | Male |
| Speciality | Podiatry |
| Experience | 22 Years |
| Location | 1245 S Washington Ave, Detroit Lakes, Minnesota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649281361 | NPI | - | NPPES |
| 8436453 | Medicaid | WA | |
| P00235433 | Other | WA | RAILROAD |
| 0207841 | Other | WA | L & I |
| 8905370 | Other | WA | CRIME VICTIMS |
| 0196122 | Other | WA | L & I |
| 8941204 | Other | WA | CRIME VICTIMS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | 801 (Minnesota) | Secondary |
| 213E00000X | Podiatrist | PO00000770 (Washington) | Secondary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 801 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Perham Health | Perham, MN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sanford Medical Center Fargo | 8426967803 | 1125 |
| Provider Name | Perham Hospital District |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1932113768 PECOS PAC ID: 2264327766 Enrollment ID: O20040216000182 |
| Provider Name | Perham Hospital District |
|---|---|
| Provider Type | Part A Provider - Critical Access Hospital |
| Provider Identifiers | NPI Number: 1790799518 PECOS PAC ID: 2264327766 Enrollment ID: O20061104000612 |
| Provider Name | Sanford Medical Center Fargo |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1184917924 PECOS PAC ID: 8426967803 Enrollment ID: O20110701000031 |
| Mailing Address | Practice Location Address |
|---|---|
| Andrew J Johnson, DPM 1245 S Washington Ave, Detroit Lakes, MN 56501-3905 Ph: (218) 846-2000 | Andrew J Johnson, DPM 1245 S Washington Ave, Detroit Lakes, MN 56501-3905 Ph: (218) 846-2000 |
Andrew Moen, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1027 Washington Ave, Detroit Lakes, MN 56501 Phone: 218-847-5611 Fax: 218-847-0881 | |
Dr. Benjy Olsen, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1027 Washington Ave, Detroit Lakes, MN 56501 Phone: 188-475-6112 |