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DR. DALE JOHNSON O.D.
NPI 1629029095
Optometrist in Sault Sainte Marie, MI

Active since May 12, 2006PECOS Enrolled
724 CEDAR ST, SAULT SAINTE MARIE, MI 49783(906) 632-2020 Get Directions Write a Review

NPPES record last updated: July 29, 2015. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Dale Johnson O.d. NPPES

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

DR. DALE JOHNSON O.D. (NPI 1629029095) is an individual optometrist in Sault Sainte Marie, Michigan, licensed in Michigan (4901002749) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629029095
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. DALE JOHNSONCredential: O.D.
Location Address724 CEDAR STSault Sainte Marie, MI 49783-2410
Mailing Address724 Cedar StSault Sainte Marie, MI 49783-2410 · (906) 632-2020
Phone(906) 632-2020
Sole ProprietorNo
Enumeration DateMay 12, 2006
Last NPPES UpdateJuly 29, 2015
✔ NPI 1629029095 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in MI · 4901002749
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
724 CEDAR ST, Sault Sainte Marie, MI 49783
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Other Identifiers 3

OtherDJ002749MI · Bcbs
OtherP31680002MI · Medicare Plus Blue
Medicare PINP31680002MI

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Dale Johnson O.d. 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.

Medicare Billing Reassignment

Medicare enrollment records show Dale Johnson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sault Tribe Of Chippewa Indians
1.7 mi
Optometrist
2864 ASHMUN ST
Sault Sainte Marie, MI 49783
  • Reassigned Medicare billing, Michigan enrollment
  • 4 clinicians in this Medicare group
NPI 1902074586 (906) 632-5200

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49783 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
$126.15 typical visit price
range $54.34 – $166.68
Typical copayment $31.53 (range $13.58 – $41.67)
Most-billed visit code 99204
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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

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

DALE JOHNSON OD LLC
Optometrist (Vision Therapy)
724 CEDAR ST
SAULT SAINTE MARIE, MI 49783
Chippewa County (906) 632-2020

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 Dale Johnson's NPI number?

The NPI number for Dale Johnson is 1629029095. It was assigned to this individual provider in the NPPES registry on May 12, 2006.

Where is Dale Johnson located?

Dale Johnson practices at 724 Cedar St, Sault Sainte Marie, MI 49783. The listed phone number is (906) 632-2020.

What is Dale Johnson's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Dale Johnson enrolled in Medicare?

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

Which organization bills Medicare for Dale Johnson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dale Johnson reassigns Medicare benefits to Sault Tribe Of Chippewa Indians (Sault Sainte Marie, MI). The 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 Dale Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Dale Johnson was last updated on July 29, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.