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DR. THEODORE SAMUEL JOHNSON M.D., PH.D.
NPI 1255453759
Pediatrics - Pediatric Hematology-Oncology in Augusta, GA

Active since April 04, 2007PECOS EnrolledAccepts Medicare Assignment
1120 FIFTEENTH STREET, CN-4141A, AUGUSTA, GA 30912(706) 721-3626(706) 721-4804 Get Directions Write a Review

NPPES record last updated: June 15, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Theodore Samuel Johnson M.d., Ph.d. NPPES

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

DR. THEODORE SAMUEL JOHNSON M.D., PH.D. (NPI 1255453759) is an individual pediatric hematology-oncology provider in Augusta, Georgia, licensed in Georgia (64115) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS and is a graduate of Medical College Of Georgia School Of Medicine (2004).

NPPES Registry Identity

NPI1255453759
Entity TypeIndividualMale
Primary Taxonomy2080P0207X
Provider Legal NameDR. THEODORE SAMUEL JOHNSONCredential: M.D., PH.D.
Location Address1120 FIFTEENTH STREET, CN-4141AAugusta, GA 30912
Mailing Address1120 Fifteenth Street, Cn-4141aAugusta, GA 30912 · (706) 721-3626 · Fax (706) 721-4804
Phone(706) 721-3626
Fax(706) 721-4804
Sole ProprietorNo
Medical School CMSMedical College Of Georgia School Of MedicineGraduated 2004
Enumeration DateApril 4, 2007
Last NPPES UpdateJune 15, 2017
✔ NPI 1255453759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Hematology-OncologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0207X
License✔ Licensed in GA · 64115
Definition
A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases.
1120 FIFTEENTH STREET, CN-4141A, Augusta, GA 30912
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Theodore Samuel Johnson M.d., Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1658402839
PECOS Enrollment IDI20100702000164
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 Theodore Johnson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Au Medical Associates Inc
0.1 mi
Multi-Specialty
1120 15TH ST
Augusta, GA 30912
  • Reassigned Medicare billing, Georgia enrollment
  • 1,151 clinicians in this Medicare group
NPI 1841230620 (706) 721-2273
Wellstar Medical Group, LLC
140 mi
Family Medicine
11685 ALPHARETTA HWY, SUITE 300
Roswell, GA 30076
  • Reassigned Medicare billing, Georgia enrollment
  • 3,885 clinicians in this Medicare group
NPI 1922405729 (678) 325-6611

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

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 Theodore Johnson's NPI number?

The NPI number for Theodore Johnson is 1255453759. It was assigned to this individual provider in the NPPES registry on April 4, 2007.

Where is Theodore Johnson located?

Theodore Johnson practices at 1120 Fifteenth Street, Cn-4141a, Augusta, GA 30912. The listed phone number is (706) 721-3626.

What is Theodore Johnson's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Hematology-Oncology, with taxonomy code 2080P0207X.

Is Theodore Johnson enrolled in Medicare?

Yes. Theodore Johnson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Theodore Johnson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Theodore Johnson reassigns Medicare benefits to 2 organizations: Au Medical Associates Inc (Augusta, GA) and Wellstar Medical Group, LLC (Roswell, GA). 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 Theodore Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Theodore Johnson accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 2 other insurers list Theodore 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 Theodore Johnson was last updated on June 15, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.