DR. SHELLY JOHNSON (MD) – Internal Medicine Physician, NPI 1528055191
Internal Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
1,158 INTERNAL MEDICINE in RI
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Provider Addresses for DR. SHELLY JOHNSON (MD)
70, Kenyon Avenue, Wakefield, South Kingstown, South County, Rhode Island, 02879, United States
SUITE 215
WAKEFIELD, RI 028794239
Phone: (401) 783-0084
Fax: (401) 782-0005
Type: Location
Davol Square, Downtown, Providence, Providence County, Rhode Island, 02903, United States
SUITE 400
PROVIDENCE, RI 029034754
Phone: (401) 421-4000
Fax: (401) 272-1456
Type: Mailing
59 S COUNTY COMMONS WAY FL H32
SOUTH KINGSTOWN, RI 028798270
Phone: (401) 783-0084
Fax: (401) 782-0005
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: 2004-06-28
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 |
|---|---|---|---|---|
| I20040628000640 | I | Internal Medicine | RI | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 438 | 274 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 204 | 149 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 146 | 132 | $0 |
| G0008 | Administration of influenza virus vaccine | 89 | 88 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 62 | 61 | $0 |
Insurance plans in this area (ZIP 02879)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | RI | |
| Internal Medicine | RI | |
| Physician Assistant | RI | |
| Physician Assistant | RI | |
| Nurse Practitioner | RI | |
| Physician Assistant | RI | |
| Physician Assistant | RI | |
| Family Practice | RI | |
| Nurse Practitioner | RI | |
| Nurse Practitioner | RI |
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