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DR. EVAN JAMES JOHNSON MD
NPI 1053999847
Student in an Organized Health Care Education/Training Program in Minneapolis, MN

Active since April 01, 2021PECOS Enrolled
420 DELAWARE ST SE MMC195, MINNEAPOLIS, MN 55455(612) 625-6483 Get Directions Write a Review

NPPES record last updated: July 3, 2025. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Jul 3, 2025, May 14, 2025, Mar 17, 2025 and 1 more (4 updates tracked since 2021).

About Dr. Evan James Johnson Md NPPES

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

DR. EVAN JAMES JOHNSON MD (NPI 1053999847) is an individual student in an organized health care education/training program in Minneapolis, Minnesota and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053999847
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. EVAN JAMES JOHNSONCredential: MD
Location Address420 DELAWARE ST SE MMC195Minneapolis, MN 55455
Mailing Address420 Delaware St Se Mmc195Minneapolis, MN 55455 · (612) 625-6483
Phone(612) 625-6483
Sole ProprietorNo
Enumeration DateApril 1, 2021
Last NPPES UpdateJuly 3, 20254 updates tracked since enumeration
NPPES CertifiedJune 23, 2025
✔ NPI 1053999847 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
420 DELAWARE ST SE MMC195, Minneapolis, MN 55455
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Evan James Johnson Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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 Evan Johnson's NPI number?

The NPI number for Evan Johnson is 1053999847. It was assigned to this individual provider in the NPPES registry on April 1, 2021.

Where is Evan Johnson located?

Evan Johnson practices at 420 Delaware St SE Mmc195, Minneapolis, MN 55455. The listed phone number is (612) 625-6483.

What is Evan Johnson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Evan Johnson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Evan Johnson was last updated on July 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.