MARIAH SAMUELLE JOHNSON MD
NPI 1083401483
Student in an Organized Health Care Education/Training Program in Philadelphia, PA

Q: What is Mariah Johnson's NPI number?

The NPI number for Mariah Johnson is 1083401483. It was assigned to this individual provider in the NPPES registry on April 21, 2025.

Q: What is Mariah Johnson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Mariah Johnson was last updated on May 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since April 21, 2025PECOS Enrolled

901 WALNUT ST FL 4, PHILADELPHIA, PA 19107(215) 955-9425(215) 503-4347 Get Directions Write a Review

NPPES record last updated: May 4, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mariah Samuelle Johnson Md NPPES

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

MARIAH SAMUELLE JOHNSON MD (NPI 1083401483) is an individual student in an organized health care education/training program in Philadelphia, Pennsylvania and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083401483

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameMARIAH SAMUELLE JOHNSONCredential: MD

Location Address901 WALNUT ST FL 4Philadelphia, PA 19107-5214

Mailing Address357 Newport Ave Apt 4eQuincy, MA 02170-3359 · (717) 585-1427

Phone(215) 955-9425

Fax(215) 503-4347

Sole ProprietorNo

Enumeration DateApril 21, 2025

Last NPPES UpdateMay 4, 2026

NPPES CertifiedMay 4, 2026

✔ NPI 1083401483 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.

901 WALNUT ST FL 4, Philadelphia, PA 19107

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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)

Mariah Samuelle 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.

Other Providers at the Same Location NPPES 20

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

LEAH SHABO MD

Student in an Organized Health Care Education/Training Program