MATTHEW MICHAEL JOHNSON (DO) – Psychiatry Physician, NPI 1396173746
Psychiatry Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
1,648 PHYSICIAN ASSISTANT in IA
Provider Addresses for MATTHEW MICHAEL JOHNSON (DO)
1111 6th Ave
Des Moines, IA 503142613
Phone: (515) 643-8350
Fax: (515) 643-5824
Type: Location
1021 Bandana Blvd E Ste 100
Saint Paul, MN 551085109
Phone: (651) 241-9700
Type: Location
14000 NICOLLET AVE FL 1
BURNSVILLE, MN 553375790
Phone:
Type: Mailing
PO BOX 1475
DES MOINES, IA 503051475
Phone: (515) 643-2682
Fax: (515) 643-5802
Type: Mailing
1111 6TH AVE
DES MOINES, IA 503142613
Phone: (515) 643-2682
Fax: (515) 643-5802
Type: Location
2925 CHICAGO AVE
MINNEAPOLIS, MN 554071321
Phone: (612) 262-9000
Type: Mailing
520 OSBORNE RD NE STE 210
FRIDLEY, MN 554322718
Phone: (763) 236-3800
Fax: (763) 236-3821
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2025-08-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20131216001532 | I | Physician Assistant | MN | TBD |
| I20231221003208 | I | Psychiatry | IA | TBD |
| I20250804000667 | I | Psychiatry | MN | 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 50314)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pulmonary Disease | CO | |
| Qualified Audiologist | MN | |
| Family Practice | MN | |
| - | MN | |
| Family Practice | MN | |
| Nurse Practitioner | ND | |
| - | MN | |
| - | MN | |
| - | MN | |
| - | MN |
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