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

Individual provider Neurological Surgery Physician · NPI 1578501797

Mark D Johnson, MDPHD is a Neurosurgery in Worcester, Massachusetts. Graduated from Harvard Medical School in 1995, 31 years ago. Practices with Umass Memorial Medical Group Inc, a 2,467-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Massachusetts.

Years since qualifying
31
Trained at
Harvard Medical School
Licensed in
MA
In the registry since
2006
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Practice location Address checks out

55 Lake Ave N
Worcester, MA 01655-0002
Phone: (508) 856-2963
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurological Surgery Physician (primary) Taxonomy 207T00000X · Licence 217384 (MA)

Record details

NPI number1578501797
Entity typeIndividual (Type 1)
GenderMale
Credentials MDPHD
Sole proprietorNo
NPI enumeratedJune 2, 2006
Last updated in NPPESOctober 26, 2020
Certification dateOctober 26, 2020
Mailing addressPo Box 415348, Boston, MA 02241-5348

Medicare enrollment

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

Medicare specialtyNEUROSURGERY
Medical schoolHARVARD MEDICAL SCHOOL
Graduated 1995 (31 years in practice)
Group practice Umass Memorial Medical Group Inc — 2467 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Worcester