ETHAN JOHNSTON MD
NPI 1457939142
Psychiatry & Neurology - Psychiatry in Maywood, IL

Q: What is Ethan Johnston's NPI number?

The NPI number for Ethan Johnston is 1457939142. It was assigned to this individual provider in the NPPES registry on April 1, 2021.

Q: What is Ethan Johnston's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Q: When was this NPI record last updated?

The NPPES record for Ethan Johnston was last updated on July 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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 01, 2021PECOS EnrolledAccepts Medicare Assignment

2160 S 1ST AVE, MAYWOOD, IL 60153(708) 216-9000 Get Directions Write a Review

NPPES record last updated: July 31, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Ethan Johnston Md NPPES

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

ETHAN JOHNSTON MD (NPI 1457939142) is an individual psychiatry provider in Maywood, Illinois, licensed in Illinois (036176111) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS, is affiliated with Loyola University Medical Center, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1457939142

Entity TypeIndividualMale

Primary Taxonomy2084P0800X

Provider Legal NameETHAN JOHNSTONCredential: MD

Location Address2160 S 1ST AVEMaywood, IL 60153-3328

Mailing Address2160 S 1st AveMaywood, IL 60153-3328 · (708) 216-9000

Phone(708) 216-9000

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateApril 1, 2021

Last NPPES UpdateJuly 31, 2025

NPPES CertifiedJuly 31, 2025

✔ NPI 1457939142 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

License✔ Licensed in IL · 036176111

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

2160 S 1ST AVE, Maywood, IL 60153

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.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

Ethan Johnston Md 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 ID9133521016

PECOS Enrollment IDI20250812000522

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

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

Loyola University Medical Center

Same address

General Practice

2160 S 1ST AVE
Maywood, IL 60153

Reassigned Medicare billing, Illinois enrollment
1,138 clinicians in this Medicare group

NPI 1336159961 (708) 216-3215

Loyola Medical Group LLC

2.9 mi

General Practice

3249 OAK PARK AVE
Berwyn, IL 60402

Reassigned Medicare billing, Illinois enrollment
211 clinicians in this Medicare group

NPI 1376041954 (708) 783-3125

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

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Loyola University Medical Center

Acute Care Hospitals · Maywood, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140276

Location2160 S 1st AvenueMaywood, IL 60153 · Cook County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60153 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

$183.39 typical visit price

range $60.08 – $183.39

Typical copayment $45.84 (range $15.02 – $45.84)

Most-billed visit code 99205

Established Patient

$74.80 typical visit price

range $18.97 – $148.12

Typical copayment $18.70 (range $4.74 – $37.03)

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 20

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

ANITA OZA NAGAMINE M.D.

Radiology (Diagnostic Radiology)