PAUL DAVID JOHNSON MD
NPI 1245596410
Psychiatry & Neurology - Neurology in Aurora, CO


Quality Rating: 58.48 out of 100 score

NPI Status: Active since April 02, 2012

Contact Information

12605 E 16TH AVE
AURORA, CO
ZIP 80045
Phone: (303) 493-7000

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  • Individual
  • Male
  • Years of Experience 14
  • Psychiatry & Neurology
  • Neurology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About PAUL JOHNSON

This page provides the complete NPI Profile along with additional information for Paul Johnson, a provider established in Aurora, Colorado with a medical specialization in Psychiatry & Neurology, focusing in neurology and more than 14 years of experience. He graduated from Michigan State University College Of Human Medicine in 2012. The healthcare provider is registered in the NPI registry with number 1245596410 assigned on April 2012. The practitioner's primary taxonomy code is 2084N0400X with license number DR.0058515 (CO). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI
1245596410
Provider Name
PAUL DAVID JOHNSON MD
Gender
Male
Entity Type
Individual
Location Address
12605 E 16TH AVE AURORA, CO 80045
Location Phone
(303) 493-7000
Mailing Address
PO BOX 110429 AURORA, CO 80042
Mailing Phone
(303) 493-7000
Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Graduation Year
2012
Is Sole Proprietor?
No
Enumeration Date
04-02-2012
Last Update Date
06-11-2018
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Psychiatry & Neurology Neurology

Taxonomy Code
2084N0400X
Type
Allopathic & Osteopathic Physicians
License No.
DR.0058515
License State
CO
Taxonomy Description
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Med Benchmark Expanded Bronze Select Copay Plan - HMO
  • Med Benchmark Expanded Bronze Standardized Plan - HMO
  • Med Benchmark Gold Standardized Plan - HMO
  • Med Benchmark Platinum - HMO
  • Med Benchmark Platinum Standardized Plan - HMO
  • Med Benchmark Silver 6000 Medical Deductible w/Vision - HMO
  • Med Benchmark Silver Standardized Plan - HMO
  • Med Gold 1500 Medical Deductible - HMO
  • Signature Benchmark Gold - HMO
  • Signature Benchmark Gold Standardized Plan - HMO
  • Signature Benchmark Silver 5900 Medical Deductible - HMO
  • Signature Benchmark Silver Standardized Plan - HMO
  • Value Benchmark Expanded Bronze Select Copay Plan - HMO
  • Value Benchmark Gold Standardized Plan - HMO
  • Value Benchmark Platinum - HMO
  • Value Benchmark Platinum Standardized Plan - HMO
  • Value Benchmark Silver 5900 Medical Deductible - HMO
  • Value Benchmark Silver Standardized Plan - HMO
  • Value Expanded Bronze 6900 Medical Deductible - HMO
  • Value Gold 1500 Medical Deductible - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Paul Johnson is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Paul Johnson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 345511127

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20181027000183

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Follow-up hospital inpatient care per day, typically 25 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 77 times for 44 patients

Hospital discharge day management, 30 minutes or less

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

This service was performed 41 times for 41 patients

Hospital discharge day management, more than 30 minutes

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

This service was performed 13 times for 12 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 35 times for 35 patients

Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth

A Telehealth consultation is a virtual medical appointment. In an emergency department or initial inpatient scenario, a healthcare professional interacts with you through a secured video call for about 50 minutes. It allows you to receive care without physically being in the hospital.

This service was performed 12 times for 12 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $33.13 for a new patient copayment and $25.5 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 80045 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $132.55
  • Minimum New Patient Price $58.06
  • Maximum New Patient Price $174.82
  • Average New Patient Copayment $33.13
  • Minimum New Patient Copayment $14.51
  • Maximum New Patient Copayment $43.7

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $102.03
  • Minimum Established Patient Price $18.88
  • Maximum Established Patient Price $142.79
  • Average Established Patient Copayment $25.5
  • Minimum Established Patient Copayment $4.72
  • Maximum Established Patient Copayment $35.69

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 58.48, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 58.48 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 76.44

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 0

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: 68.51

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: 68.51

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Paul Johnson is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
INTERMOUNTAIN MEDICAL CENTER5121 SOUTH COTTONWOOD STREET
MURRAY, UT 84107
(801) 507-7000Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1245596410
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
22851091242
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 8 + 5 + 1 + 0 + 9 + 1 + 2 + 4 + 2 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1245596410 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1992701411 ELIZABETH CERIMELE CRNA
Individual
Nurse Anesthetist, Certified Registered12605 E 16TH AVE
AURORA, CO 80045
(720) 848-0000
1700884541 RUTH E PARKER CNM
Individual
Advanced Practice Midwife12605 E 16TH AVE UNIVERSITY OF COLORADO HOSPITAL
AURORA, CO 80045
(720) 848-0000
1205826120DR. JAMES EATON MD
Individual
Radiology (Diagnostic Radiology)12605 E 16TH AVE
AURORA, CO 80045
(720) 848-0000
1972594190 ERIN WELCH MD
Individual
Dermatology12605 E 16TH AVE
AURORA, CO 80045
(720) 848-0000
1437130101 NEKO UPSON CNM
Individual
Advanced Practice Midwife12605 E 16TH AVE
AURORA, CO 80045
(720) 848-0000
1346222114DR. ANGELA M DAVIES M.D.
Individual
Internal Medicine (Hematology & Oncology)12605 E 16TH AVE
AURORA, CO 80045
(720) 848-0000
1013993526 MICHAEL JOBIN MD
Individual
Emergency Medicine12605 E 16TH AVE
AURORA, CO 80045
(720) 848-0000
1740266964 TODD GUTH MD
Individual
Emergency Medicine12605 E 16TH AVE
AURORA, CO 80045
(720) 848-0000
1831169952 JAVIER WAKSMAN MD
Individual
Internal Medicine12605 E 16TH AVE
AURORA, CO 80045
(720) 848-0000
1285605535 MONICA WAZIRI CRNA
Individual
Nurse Anesthetist, Certified Registered12605 E 16TH AVE
AURORA, CO 80045
(720) 848-0000
1215903174 KENNETH TYLER MD
Individual
Psychiatry & Neurology (Clinical Neurophysiology)12605 E 16TH AVE
AURORA, CO 80045
(720) 848-0000
1831166701 DANIEL MERRICK MD
Individual
Pathology (Anatomic Pathology & Clinical Pathology)12605 E 16TH AVE
AURORA, CO 80045
(720) 848-0000
1730157942 DONNA LILLY CRNA
Individual
Nurse Anesthetist, Certified Registered12605 E 16TH AVE
AURORA, CO 80045
(720) 848-0000
1861453128 SARAH CHILTON MD
Individual
Radiology (Body Imaging)12605 E 16TH AVE
AURORA, CO 80045
(720) 848-0000
1609838770 BETTYANN HEPPLER CNM
Individual
Advanced Practice Midwife12605 E 16TH AVE
AURORA, CO 80045
(720) 848-0000
1659334324 KATHLEEN MITCHELL CRNA
Individual
Nurse Anesthetist, Certified Registered12605 E 16TH AVE
AURORA, CO 80045
(720) 848-0000
1568426070 PRISCILLA NODINE CNM
Individual
Advanced Practice Midwife12605 E 16TH AVE
AURORA, CO 80045
(720) 848-0000
1386600237DR. RICHARD ZANE MD
Individual
Emergency Medicine12605 E 16TH AVE
AURORA, CO 80045
(720) 848-0000
1760449607MS. CHERYL A MCGINNIS CRNA
Individual
Nurse Anesthetist, Certified Registered12605 E 16TH AVE
AURORA, CO 80045
(720) 848-0000
1558312769 JACQUELINE VASQUEZ CRNA
Individual
Nurse Anesthetist, Certified Registered12605 E 16TH AVE
AURORA, CO 80045
(720) 848-0000

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1245596410, enumerated in the NPI registry as an "individual" on April 02, 2012

The provider is located at 12605 E 16th Ave Aurora, Co 80045 and the phone number is (303) 493-7000

The provider's speciality is Psychiatry & Neurology with taxonomy code 2084N0400X with a focus in Neurology

The provider has more than 14 years of experience. He graduated from Michigan State University College Of Human Medicine in 2012.

The provider might be accepting Accepts: Select Health. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Medicare beneficiaries should expect a typical cost of $132.55 with an average copayment of $33.13 for new patient appointments. Established patients should expect a typical charge of $102.03 and an average copayment of 25.5. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Follow-up hospital inpatient care per day, typically 25 minutes, Hospital discharge day management, 30 minutes or less, Hospital discharge day management, more than 30 minutes, Initial hospital inpatient care per day, typically 70 minutes and Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth.

The practitioner is affiliated to the following hospital(s): INTERMOUNTAIN MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on April 02, 2012. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.