DR. MARK C JOHNSON (MD) – Pediatric Cardiology Physician, NPI 1497796957

DR. MARK C JOHNSON (MD) is a healthcare provider. based in Saint louis, Missouri. specializing in Pediatric Cardiology Physician. They hold the professional credentials MD. They hold a License No. 102902 (MO). The NPI Number for DR. MARK C JOHNSON (MD) is 1497796957

Main info

Male
44 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARK C JOHNSON (MD)
NPI
1497796957
Phone
(314) 454-6095
Address
1 CHILDRENS PL
Enumeration Date
8 June 2006
Last Update Date
25 April 2024

Doctor Profile

Medical School Name
JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1982 (44 years ago)
PAC ID
9931106770
Group Practice PAC ID
9830008770
Professional Enrollment ID
I20100827000314

Contacts

FHIR Endpoint
https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

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Provider Addresses for DR. MARK C JOHNSON (MD)

  • Saint Louis Childrens Hospital School, 1, Children's Place, Central West End, City of Saint Louis, Missouri, 63110, United States

    MSC 8515-87-1200

    SAINT LOUIS, MO 631101002

    Phone: (314) 454-6095

    Fax: (314) 454-2561

    Type: Mailing

  • PO BOX 60352

    SAINT LOUIS, MO 631600352

    Phone: (314) 454-6095

    Fax: (314) 454-2561

    Type: Mailing

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: 2006-11-08

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
I20061108000541ICardiovascular Disease (Cardiology)ILTBD

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 63110)

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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: 9830008770View full group profile

Reviews

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Frequently asked questions

Can I verify DR. MARK C JOHNSON (MD) with an NPI only?
You can start verification with NPI 1497796957 for DR. MARK C JOHNSON (MD), then check state licensing separately.
Does CMS list DR. MARK C JOHNSON (MD) as active?
Yes — DR. MARK C JOHNSON (MD) is active in the NPI listing used on this page.
What is DR. MARK C JOHNSON (MD) best known for clinically?
Directory data describes DR. MARK C JOHNSON (MD) with Pediatric Cardiology Physician. Clinical services aligned with this taxonomy classification.
Where should I expect DR. MARK C JOHNSON (MD) on a map?
Expect Saint Louis, Missouri as a primary anchor for DR. MARK C JOHNSON (MD) unless the record lists multiple sites.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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