Michael Olton Johnson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11074 Issued in GA

Practice address

377 W Pike St # A3-2
Lawrenceville, GA 30046-4881

Phone

(470) 461-7031

Fax

(770) 502-6820

NPI assigned

Apr 9, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, GA3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore Lij Urgent Care PCGroup PAC ID 6002131778, 389 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.johnson@ghuc.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• North Shore Lij, Urgent Care, P.C.

  • Urgent Care Clinic/Center
  • Rockville Centre, NY
  • NPI 1679970891
  Medicare reassignment Care Compare group
• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  Medicare reassignment
• Zodiac Medical LLC

  • Internal Medicine Physician
  • Lawrenceville, GA
  • NPI 1083344576
  Medicare reassignment
• Essen Medical Urgicare, PLLC

  • Urgent Care Clinic/Center
  • Bronx, NY
  • NPI 1841607298
  Medicare reassignment
• Excel Urgent Care of Astoria PLLC

  • Urgent Care Clinic/Center
  • Howard Beach, NY
  • NPI 1235434036
  Medicare reassignment
• Excel Urgent Care of East Northport, PLLC

  • Urgent Care Clinic/Center
  • East Northport, NY
  • NPI 1881978021
  Medicare reassignment
• Excel Urgent Care of Nesconset, PLLC

  • Urgent Care Clinic/Center
  • Nesconset, NY
  • NPI 1851679252
  Medicare reassignment
• Excel Urgent Care of NHP PLLC

  • Urgent Care Clinic/Center
  • New Hyde Park, NY
  • NPI 1952652281
  Medicare reassignment
• Excel Urgent Care of Wantagh PLLC

  • Urgent Care Clinic/Center
  • Wantagh, NY
  • NPI 1184067936
  Medicare reassignment
• Harlem Medical Associates PC

  • General Practice Physician
  • New York, NY
  • NPI 1487957692
  Medicare reassignment
• Port City Emergency Physicians LLP

  • Emergency Medicine Physician
  • Oswego, NY
  • NPI 1134370547
  Medicare reassignment
• Port City Emergency Physicians LLP

  • Emergency Medicine Physician
  • Hamilton, NY
  • NPI 1316395460

  Physician Assistant

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1003313727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 W PIKE ST # A3-2",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464881",
            "telephone_number": "470-461-7031",
            "fax_number": "770-502-6820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 W PIKE ST # A3-2",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464881",
            "telephone_number": "470-461-7031",
            "fax_number": "770-502-6820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHAEL",
        "middle_name": "OLTON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-09",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11074",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "021943",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren McKenzie Johnson, MSPA, PA-C
• Linda Johnson
• Maya Johnson
• Miatta Lassanah Johnson, PMHNP
• Michael Johnson, PA-C
• Pooja Johnson, RBT
• Rubi Johnson
• Shaneva Johnson
• Shanika Johnson
• Sierra Dena Johnson, LMT

• Physician Assistant in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.