Provider Demographics
NPI:1235136508
Name:JOHNSTON, JEHANE C (MD)
Entity Type:Individual
Prefix:
First Name:JEHANE
Middle Name:C
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1 LYONS ST
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-5599
Mailing Address - Country:US
Mailing Address - Phone:781-493-3570
Mailing Address - Fax:781-326-0221
Practice Address - Street 1:1 LYONS ST
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-5599
Practice Address - Country:US
Practice Address - Phone:781-493-3570
Practice Address - Fax:781-326-0221
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA150831207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
3162176OtherMASS HEALTH
150831OtherTUFTS COMMONWEALTH PPO
5439345OtherCIGNA HEALTH CARE
J16873OtherBLUE SHIELD-INDEMNITY
MA5439345OtherHEALTHSOURCE
66587OtherHARVARD/PILGRIM
66587OtherHARVARD PILGRIM POS
A21550OtherMEDICARE
J16673OtherBS-BLUE CARE ELECT
J16873OtherHMO BLUE/BLUE CHOICE
150831OtherTUFTS
27544OtherCHILDREN'S MEDICAL SEC.
66587OtherHARVARD PILGRIM PPO
MAJ16873OtherBCBS
MA3162176Medicaid
110159467OtherRAILROAD/MEDICARE
150831OtherTUFTS BENEFIT ADMIN
G32493OtherFIRST SENIORITY
27544OtherCHILDREN'S MEDICAL SEC.
G32493OtherFIRST SENIORITY