Look up the most recent NPI and PECOS records

Indley Johnson

Internal Medicine

Allopathic & Osteopathic Physicians

PECOS Enrollment

Based on the most recent information from CMS, provider Indley Johnson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1689037665
Provider Type
Individual
Full Name
Johnson, Indley
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
3/29/2016
Last Updated
9/2/2022

Contact Information

Practice Location

1000 36th St, Vero Beach, FL 32960-4862

(772) 567-4311

Unlisted Fax

Mailing Location

1000 36th St, Vero Beach, FL 32960-4862

(772) 567-4311

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207RP1001X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License ME156750 Florida
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License 302250 New York

Indley Johnson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Velasquez, Hermes Segundo

Michele Maholtz Md Pa

John S Suen Md Pa

Indian River Health Services Inc

Ronderos Botero, Diana Maria

Maldonado, Diego A

Michael P Tonner Md Pa

Maholtz, Michele