DAVID JOHNSON (MD) – Anesthesiology Physician, NPI 1104024561

DAVID JOHNSON (MD) is a healthcare provider. based in Dallas, Texas. specializing in ANESTHESIOLOGY. They hold the professional credentials MD. They hold a License No. ME177219 (FL). The NPI Number for DAVID JOHNSON (MD) is 1104024561

Main info

Male
Sole Proprietor
19 Years Of Experience
Accepts Medicare Assignment
Name
DAVID JOHNSON (MD)
NPI
1104024561
Phone
(817) 516-8811
Address
12222 N CENTRAL EXPY STE 400
Enumeration Date
6 July 2007
Last Update Date
11 November 2025

Doctor Profile

Medical School Name
BAYLOR COLLEGE OF MEDICINE
Secondary Phone
9549395000
Graduation Year
2007 (19 years ago)
PAC ID
0042482523
Group Practice PAC ID
7416928536
Professional Enrollment ID
I20251022002248
Address ID
FL328061110OR52XXXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness85
Years active:18State licenses:2Digital endpointsOther names

4,591 ANESTHESIOLOGY in TX

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Provider Addresses for DAVID JOHNSON (MD)

  • 400, North Central Expressway, Richardson, Dallas County, Texas, 75080, United States

    DALLAS, TX 752433764

    Phone: (817) 516-8811

    Fax: (817) 516-8444

    Type: Mailing

  • 12222, North Central Expressway, Dallas, Dallas County, Texas, 75251, United States

    DALLAS, TX 752433755

    Phone: (817) 516-8811

    Fax: (817) 516-8444

    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: 2025-10-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 4 Medicare enrollment records; no due dates published yet.

Enrollment records

4

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
I20171016001087IAnesthesiologyUTTBD
I20240903000694IAnesthesiologyWYTBD
I20250523001703IAnesthesiologyNCTBD
I20251022002248IAnesthesiologyFLTBD

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
00142Anesthesia for lens surgery118102$0
00103Anesthesia for procedure on eyelid2020$0
00140Anesthesia for other procedure on eye1919$0
00811Anesthesia for other procedure on large bowel using an endoscope1111$0
View full utilization report →

Insurance plans in this area (ZIP 75243)

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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: 7416928536View full group profile
NameSpecialtyState
-FL
A N E S T H E S I O L O G YFL
Certified Registered Nurse Anesthetist (Crna)FL
A N E S T H E S I O L O G YFL
A N E S T H E S I O L O G YFL
A N E S T H E S I O L O G YMA
A N E S T H E S I O L O G YND
Anesthesiology AssistantFL
Certified Registered Nurse Anesthetist (Crna)FL
Certified Registered Nurse Anesthetist (Crna)FL

Reviews

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Frequently asked questions

Does DAVID JOHNSON (MD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DAVID JOHNSON (MD) uses 1104024561.
Does the file indicate DAVID JOHNSON (MD) is practicing under active NPI?
Directory data currently reports DAVID JOHNSON (MD) as active.
What taxonomy line describes DAVID JOHNSON (MD)?
For research purposes, treat DAVID JOHNSON (MD) as Anesthesiology Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is DAVID JOHNSON (MD) based?
DAVID JOHNSON (MD) is tied to Dallas, Texas in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.