FREDERICK JOHNSON (MD) – Emergency Medicine Physician, NPI 1891780029

FREDERICK JOHNSON (MD) is a healthcare provider. based in Federal way, Washington. specializing in EMERGENCY MEDICINE. They hold the professional credentials MD. They hold a License No. 01028913 (IN). The NPI Number for FREDERICK JOHNSON (MD) is 1891780029

Main info

Male
Sole Proprietor
50 Years Of Experience
Accepts Medicare Assignment
Name
FREDERICK JOHNSON (MD)
NPI
1891780029
Phone
(253) 838-6180
Address
505 S 336TH ST
Enumeration Date
14 September 2005
Last Update Date
7 May 2008

Doctor Profile

Medical School Name
NORTHWESTERN UNIVERSITY FEINBERG MEDICAL SCHOOL
Secondary Phone
9549395000
Graduation Year
1976 (50 years ago)
PAC ID
7911988647
Group Practice PAC ID
7214113042
Professional Enrollment ID
I20081117000281
Address ID
AZ853446349PA1200XRDXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

111 EMERGENCY MEDICINE in WY

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Provider Addresses for FREDERICK JOHNSON (MD)

  • 505, South 336th Street, Federal Way, King County, Washington, 98003, United States

    SUITE 600

    FEDERAL WAY, WA 980036328

    Phone: (253) 838-6180

    Fax: (253) 838-6418

    Type: Mailing

  • Memorial Hospital of Sweetwater County, 1200, College Drive, Blairtown, Rock Springs, Sweetwater County, Wyoming, 82901, United States

    ROCK SPRINGS, WY 829015868

    Phone: (307) 352-8350

    Fax: (307) 352-8178

    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: 2008-11-17

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
I20081117000281IEmergency MedicineAZTBD

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 98003)

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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: 7214113042View full group profile
NameSpecialtyState
Emergency MedicineNV
Emergency Medicine, Undersea And Hyperbaric MedicineAZ
-AZ
Emergency MedicineAZ
Emergency MedicineAZ
Emergency MedicineAZ

Reviews

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Frequently asked questions

What is FREDERICK JOHNSON (MD)'s NPI number?
FREDERICK JOHNSON (MD)'s NPI is 1891780029 — the number used across U.S. healthcare to identify this provider.
Is there an active status for FREDERICK JOHNSON (MD)?
For scheduling context, FREDERICK JOHNSON (MD) is shown as active in the registry.
What expertise is attributed to FREDERICK JOHNSON (MD)?
FREDERICK JOHNSON (MD)'s specialty line reads Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for FREDERICK JOHNSON (MD)?
Travel planning: use Federal Way, Washington as the reference point for FREDERICK JOHNSON (MD), then confirm.
Can I trust this NPI listing for FREDERICK JOHNSON (MD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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