MR. MICHAEL JOEL JOHNSON (O.D.) – Optometrist, NPI 1780710459

MR. MICHAEL JOEL JOHNSON (O.D.) is a healthcare provider. based in Plymouth, Minnesota. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 2818 (MN). The NPI Number for MR. MICHAEL JOEL JOHNSON (O.D.) is 1780710459

Main info

Male
25 Years Of Experience
Accepts Medicare Assignment
Name
MR. MICHAEL JOEL JOHNSON (O.D.)
NPI
1780710459
Phone
Not provided
Address
3410 ROSEWOOD LN N
Enumeration Date
26 February 2007
Last Update Date
9 March 2026

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
9522045060
Graduation Year
2001 (25 years ago)
PAC ID
5496851735
Group Practice PAC ID
8921497751
Professional Enrollment ID
I20070503000404
Address ID
MN554165538MI6099XBLVD301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Digital endpointsOther names

879 OPTOMETRY in MN

Provider Addresses for MR. MICHAEL JOEL JOHNSON (O.D.)

  • 3410 ROSEWOOD LN N

    PLYMOUTH, MN 554412202

    Phone:

    Type: Mailing

  • 570 NORTHTOWN DR NE

    BLAINE, MN 554341043

    Phone: (763) 784-4081

    Type: Location

  • 570 Northtown Dr NE

    Blaine, MN 554341043

    Phone: (763) 784-4081

    Type: Location

  • 6099 WAYZATA BLVD

    ST LOUIS PARK, MN 554165538

    Phone: (952) 204-5060

    Type: Location

  • 3900 PARK NICOLLET BLVD

    ST LOUIS PARK, MN 554162505

    Phone: (952) 993-3150

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 15 Open Payments records for all available years, with a total value of $359.

Total Amount is formed as General ($359) + Research ($0) + Ownership ($0) = $359.

Last reported payment date: 2024-07-08 • Largest payer in this snapshot: Alcon Vision LLC ($150).

Total Amount

$359

General + Research + Ownership

Payments

15

Total payment records

General Amount

$359

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-08

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2007-05-03

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
I20070503000404IOptometryMNTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55441)

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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: 8921497751View full group profile
NameSpecialtyState
O P H T H A L M O L O G YMN
O P H T H A L M O L O G YMD
O P H T H A L M O L O G YMN
O P T O M E T R YMN
O P T O M E T R YMN
O P T O M E T R YMN

Reviews

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Frequently asked questions

How do I look up MR. MICHAEL JOEL JOHNSON (O.D.) by NPI?
Use NPI 1780710459 when you need to reference MR. MICHAEL JOEL JOHNSON (O.D.) in forms, claims, or directories.
Is MR. MICHAEL JOEL JOHNSON (O.D.) active in the national directory?
MR. MICHAEL JOEL JOHNSON (O.D.)'s public NPI profile is in an active state.
What kind of provider is MR. MICHAEL JOEL JOHNSON (O.D.)?
The page reflects Optometrist for MR. MICHAEL JOEL JOHNSON (O.D.). Clinical services aligned with this taxonomy classification.
Does MR. MICHAEL JOEL JOHNSON (O.D.) practice in Minnesota?
You will see Plymouth, Minnesota on file for MR. MICHAEL JOEL JOHNSON (O.D.) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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