Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bevan Ellis Johnson, MD, MBA

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1639798580

Bevan Ellis Johnson, MD, MBA is an Emergency Medicine in Indianapolis, Indiana. Graduated from Texas a & M University System, Hsc, College of Medicine in 2020, 6 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
6
Trained at
Texas a & M University System, Hsc, College of Medicine
Licensed in
IN
In the registry since
2020
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.
MBA — Master of Business Administration
A graduate business degree.

See every abbreviation used in this directory →

Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Indianapolis, IN
Fax: (317) 963-5492

Additional practice locations (1)

  • 1701 N Senate Blvd # Ag012, Indianapolis, IN 46202-1239 — (317) 962-5975

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 01086630A (IN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (IN)

Record details

NPI number1639798580
Entity typeIndividual (Type 1)
GenderMale
Credentials MD , MBA
Sole proprietorNo
NPI enumeratedApril 10, 2020
Last updated in NPPESJuly 6, 2022
Certification dateJuly 6, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolTEXAS A & M UNIVERSITY SYSTEM, HSC, COLLEGE OF MEDICINE
Graduated 2020 (6 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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