DR. SCOTT RAYMOND JOHNSON (MD) – Surgery Physician, NPI 1104896133
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,028 GENERAL SURGERY in MA
Provider Addresses for DR. SCOTT RAYMOND JOHNSON (MD)
110 Francis St
LMOB 7
Boston, MA 022155501
Phone: (617) 632-9824
Fax: (617) 632-9820
Type: Location
25 Hospital Dr
Bridgton, ME 040091167
Phone: (207) 647-4234
Fax: (207) 647-6260
Type: Location
12 High St Ste 401
Lewiston, ME 042407690
Phone: (207) 795-5767
Fax: (207) 795-2732
Type: Location
420 Franklin St
Rumford, ME 042762104
Phone: (207) 369-1106
Fax: (207) 369-1180
Type: Location
12, High Street, Lewiston, Androscoggin County, Maine, 04240, United States
LEWISTON, ME 042407676
Phone: (207) 795-5767
Fax: (207) 795-2732
Type: Mailing
High Street, Lewiston, Androscoggin County, Maine, 04240, United States
LEWISTON, ME 042407690
Phone: (207) 795-5767
Fax: (207) 795-2732
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: 2018-01-16
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 |
|---|---|---|---|---|
| I20180116000085 | I | General Surgery | ME | 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 02215)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | AL | |
| P O D I A T R Y | ME | |
| Certified Registered Nurse Anesthetist (Crna) | ME | |
| Nurse Practitioner | ME | |
| - | ME | |
| - | OR | |
| - | ME | |
| Critical Care (Intensivists), Sleep Medicine, Critical Care (Intensivists), Pulmonary Disease, Pulmonary Disease | ME | |
| - | NH | |
| Nurse Practitioner | ME |
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