MARK ROLFE JOHNSON (MD) – Internal Medicine Physician, NPI 1043202393

MARK ROLFE JOHNSON (MD) is a healthcare provider. based in Boerne, Texas. specializing in Internal Medicine Physician. They hold the professional credentials MD. They hold a License No. 184901-1205 (UT). The NPI Number for MARK ROLFE JOHNSON (MD) is 1043202393

Main info

Male
38 Years Of Experience
Accepts Medicare Assignment
Name
MARK ROLFE JOHNSON (MD)
NPI
1043202393
Phone
(830) 267-4575
Address
113 PLEASANT VALLEY DR STE 210
Enumeration Date
22 August 2005
Last Update Date
23 April 2020

Doctor Profile

Medical School Name
UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Secondary Phone
8302674575
Graduation Year
1988 (38 years ago)
PAC ID
8022918788
Group Practice PAC ID
2466880851
Professional Enrollment ID
I20040109001084
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

Provider Addresses for MARK ROLFE JOHNSON (MD)

  • 113 PLEASANT VALLEY DR STE 210

    BOERNE, TX 780065683

    Phone: (830) 267-4575

    Fax: (830) 214-2576

    Type: Mailing

  • 32 W 200 S # 410

    SALT LAKE CITY, UT 841011603

    Phone: (801) 960-4890

    Fax: (801) 960-4890

    Type: Location

  • 1899 E Siesta Dr

    Sandy, UT 840936241

    Phone: (801) 631-8210

    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: 2004-01-09

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
I20040109001084IInternal MedicineUTTBD

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 78006)

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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: 2466880851View full group profile
NameSpecialtyState
Nurse PractitionerTX
Physician AssistantUT
Clinical Social WorkerWY
General Practice, Family PracticeTX

Reviews

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Frequently asked questions

Can I cross-check MARK ROLFE JOHNSON (MD) using NPI 1043202393?
NPI 1043202393 belongs to MARK ROLFE JOHNSON (MD); compare other details if you need extra assurance.
Is MARK ROLFE JOHNSON (MD) shown as active in public data?
Registry records indicate MARK ROLFE JOHNSON (MD) maintains an active NPI.
What expertise is attributed to MARK ROLFE JOHNSON (MD)?
MARK ROLFE JOHNSON (MD)'s specialty line reads Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Is MARK ROLFE JOHNSON (MD) located near Boerne?
MARK ROLFE JOHNSON (MD) currently maps to Boerne, Texas in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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