DR. SHANEETA JOHNSON (M.D.) – Surgery Physician, NPI 1093995334
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. SHANEETA JOHNSON (M.D.)
33 Upper Riverdale Rd SW
Suite 121
Riverdale, GA 302742626
Phone: (770) 897-7546
Fax: (770) 991-8521
Type: Location
33, Upper Riverdale Road, Sherwood Park, Riverdale, Clayton County, Georgia, 30274, United States
SUITE 121
RIVERDALE, GA 302742626
Phone: (770) 897-7546
Fax: (770) 991-8521
Type: Location
80 JESSE HILL JR DR SE
ATLANTA, GA 303033031
Phone: (404) 616-1000
Type: Location
Morehouse School of Medicine, 720, Westview Drive Southwest, Joel Chandler Harris Homes, Atlanta, Georgia, 30310, United States
HARRIS BLDG., 100-A
ATLANTA, GA 30310
Phone: (404) 756-1400
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $6,686.
Total Amount is formed as General ($6,686) + Research ($0) + Ownership ($0) = $6,686.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: Baxter Healthcare ($6,671).
Total Amount
$6,686
General + Research + Ownership
Payments
11
Total payment records
General Amount
$6,686
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Baxter Healthcare | $6,671 |
| Janssen Biotech, Inc. | $15 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2012-09-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20120919000446 | I | General Surgery | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30274)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| Infectious Disease, Internal Medicine | GA | |
| Family Practice | GA | |
| Nurse Practitioner | GA | |
| Family Practice | GA | |
| N E U R O L O G Y | CT | |
| P S Y C H I A T R Y | GA | |
| Cardiovascular Disease (Cardiology), Internal Medicine | GA | |
| Cardiovascular Disease (Cardiology), Interventional Cardiology | GA |
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