DR. BRAD A JOHANSON (DPT) – Orthopedic Physical Therapist, NPI 1407289622

DR. BRAD A JOHANSON (DPT) is a healthcare provider. based in Grand rapids, Michigan. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 5501303790 (MI). The NPI Number for DR. BRAD A JOHANSON (DPT) is 1407289622

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
DR. BRAD A JOHANSON (DPT)
NPI
1407289622
Phone
(616) 248-9842
Address
1331 LAKE DR SE STE 105
Enumeration Date
12 August 2013
Last Update Date
11 September 2025

Doctor Profile

Medical School Name
EMORY UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6162489842
Graduation Year
2013 (13 years ago)
PAC ID
4284868993
Group Practice PAC ID
0345562187
Professional Enrollment ID
I20180124001320
Address ID
MI495061674GR1331XSEXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness85
Years active:12State licenses:1Digital endpointsOther names

2,871 PHYSICAL THERAPIST IN PRIVATE PRACTICE in GA

Provider Addresses for DR. BRAD A JOHANSON (DPT)

  • 1331 LAKE DR SE STE 105

    GRAND RAPIDS, MI 495061674

    Phone: (616) 248-9842

    Fax: (616) 248-9848

    Type: Mailing

  • 3300 NORTHEAST NEEXPY 8

    ATLANTA, GA 303413321

    Phone: (770) 500-3848

    Type: Mailing

  • 2191 NORTHLAKE PKWY

    BUILDING 11 SUITE 31

    TUCKER, GA 300844166

    Phone: (770) 491-6004

    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: 2018-01-24

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180124001320IPhysical Therapist In Private PracticeMITBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97140Therapy procedure using manual technique, each 15 minutes10515$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes10316$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes10018$0
View full utilization report →

Insurance plans in this area (ZIP 49506)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0345562187View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeIL

Reviews

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Frequently asked questions

How is DR. BRAD A JOHANSON (DPT) identified in CMS data?
CMS-hosted NPPES data lists DR. BRAD A JOHANSON (DPT) with NPI 1407289622.
Can I rely on DR. BRAD A JOHANSON (DPT) being an active provider?
As of the registry snapshot, DR. BRAD A JOHANSON (DPT) is marked active.
What is DR. BRAD A JOHANSON (DPT) best known for clinically?
Directory data describes DR. BRAD A JOHANSON (DPT) with Orthopedic Physical Therapist. Clinical services aligned with this taxonomy classification.
What address line appears for DR. BRAD A JOHANSON (DPT)?
DR. BRAD A JOHANSON (DPT)'s geographic hint is Grand Rapids, Michigan in our summary view.
Is the information about DR. BRAD A JOHANSON (DPT) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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