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SAMUEL JOHNSON
NPI 1013434299
Social Worker - Clinical in Minneapolis, MN

Active since August 28, 2017PECOS Enrolled
219 SE MAIN ST STE 400, MINNEAPOLIS, MN 55414(612) 886-2524(612) 886-2538 Get Directions Write a Review

NPPES record last updated: September 23, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 23, 2022, Aug 28, 2017 (2 updates tracked since 2017).

About Samuel Johnson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL JOHNSON (NPI 1013434299) is an individual clinical provider in Minneapolis, Minnesota, licensed in Minnesota (29698) and active in the NPI registry since August 2017. He is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1013434299
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameSAMUEL JOHNSON
Location Address219 SE MAIN ST STE 400Minneapolis, MN 55414-2151
Mailing Address219 Se Main St Ste 400Minneapolis, MN 55414-2151 · (612) 886-2524 · Fax (612) 886-2538
Phone(612) 886-2524
Fax(612) 886-2538
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateAugust 28, 2017
Last NPPES UpdateSeptember 23, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 23, 2025
✔ NPI 1013434299 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in MN · 29698
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
219 SE MAIN ST STE 400, Minneapolis, MN 55414
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel Johnson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2769877562
PECOS Enrollment IDI20220314001676
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Samuel Johnson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Stone Arch Psychology And Health Services
Same address
Clinical
219 MAIN ST SE STE 400
Minneapolis, MN 55414
  • Reassigned Medicare billing, Minnesota enrollment
  • 12 clinicians in this Medicare group
NPI 1124398607 (612) 886-2524
Nystrom & Associates, Ltd
6.9 mi
Clinical
1900 SILVER LAKE RD NW, SUITE 110
New Brighton, MN 55112
  • Reassigned Medicare billing, Minnesota enrollment
  • 794 clinicians in this Medicare group
NPI 1396750188 (651) 628-9566

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 1 hour 90837
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.
143 services26 patients
Psychiatric diagnostic evaluation 90791
A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.
26 services26 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55414 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $56.00 – $168.28
Typical copayment $0.00 (range $14.00 – $42.07)
Most-billed visit code NA
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SUSAN GUSTAFSON LP
Psychologist (Clinical)
219 SE MAIN ST STE 400
MINNEAPOLIS, MN 55414
Hennepin County (612) 886-2524
MR. DAVID WESLEY WERNER LICSW
Social Worker (Clinical)
219 SE MAIN ST STE 400
MINNEAPOLIS, MN 55414
Hennepin County (612) 886-2524
DR. LISA JENNET TRUMP PH.D., LMFT
Psychologist (Family)
219 SE MAIN ST STE 400
MINNEAPOLIS, MN 55414
Hennepin County
KRISTEN ELIZABETH RACHEL DOUCETTE MA, LPCC
Counselor (Mental Health)
219 SE MAIN ST STE 400
MINNEAPOLIS, MN 55414
Hennepin County (612) 886-2524
STEPHANIE M MICHAELS PSYD, LP
Psychologist (Counseling)
219 SE MAIN ST STE 400
MINNEAPOLIS, MN 55414
Hennepin County (612) 886-2524
MS. JENNIFER ANN LACROIX MA, LMFT
Marriage & Family Therapist
219 SE MAIN ST STE 400
MINNEAPOLIS, MN 55414
Hennepin County (612) 886-2524
MATTHEW JOHNSON MA LPCC
Counselor (Professional)
219 SE MAIN ST STE 400
MINNEAPOLIS, MN 55414
Hennepin County (612) 886-2524
RAPHAEL ANTHONY SZYKOWSKI LICSW
Social Worker (Clinical)
219 SE MAIN ST STE 400
MINNEAPOLIS, MN 55414
Hennepin County (612) 886-2524

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel Johnson's NPI number?

The NPI number for Samuel Johnson is 1013434299. It was assigned to this individual provider in the NPPES registry on August 28, 2017.

Where is Samuel Johnson located?

Samuel Johnson practices at 219 SE Main St Ste 400, Minneapolis, MN 55414. The listed phone number is (612) 886-2524.

What is Samuel Johnson's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Samuel Johnson enrolled in Medicare?

Yes. Samuel Johnson is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Samuel Johnson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Johnson reassigns Medicare benefits to 2 organizations: Stone Arch Psychology And Health Services (Minneapolis, MN) and Nystrom & Associates, Ltd (New Brighton, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samuel Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Samuel Johnson accept?

Health plans from HealthPartners list Samuel Johnson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Samuel Johnson was last updated on September 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.