Physician Compare National (NPI:1902895782)

HEALTHCARE PROVIDER: PAUL COLONIUS JOHNSON IV M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1902895782
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6002819810
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200603001097
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	JOHNSON
	Individual professional last name
Provider First Name	PAUL
	Individual professional first name
Provider Name Suffix Text	IV
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	UNIFORMED SERVICES UHS FE HEBERT SCHOOL OF MED
	Individual professional's medical school
Graduation Year	1992
	Individual professional's medical school graduation year
Primary Specialty	OTOLARYNGOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	METHODIST ASSOCIATES IN HEALTHCARE INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	6406755651
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	148
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2301 S BROAD ST
	Group Practice or individual's line 1 address
City	PHILADELPHIA
	Group Practice or individual's city
State	PA
	Group Practice or individual's state
Zip Code	191483542
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	390115
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ARIA HEALTH
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y