Alicia L Johnson, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Elbridge, NY
NPI 1003563768 · NPPES record last updated Feb 8, 2024
Key facts
- NPI
- 1003563768
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- F347820 (NY)
- Practice address
- 5566 Jordan Rd
Elbridge, NY 13060-9617 - Phone
- (315) 689-1833
- Fax
- (315) 389-1834
- NPI assigned
- Mar 3, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Familycare Medical Group PC
Practice addresses (Care Compare)
5566 Jordan Rd
Elbridge, NY 13060-9617
Phone (315) 689-1833
Hospital & facility affiliations
- Centerwell Home Health
- Auburn Community Hospital
- University Hospital S U N Y Health Science Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220405002396 | NY | Practitioner - Nurse Practitioner | 5597151266 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F347820 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Auburn Community Hospital | Current |
Accepting new patients | |
| Auburn Memorial Medical Services, PC | Current |
Accepting new patients | |
| Auburn Community Hospital | Current |
Accepting new patients | |
| Familycare Medical Group, PC | Current |
Accepting new patients | |
| Auburn Memorial Medical Services, PC | Current |
Accepting new patients |
Locations
17 E Genesee St
Ste 101
Auburn, NY 13021
Phone (315) 252-7434
17 Lansing St
Ste 202
Auburn, NY 13021
Phone (315) 567-0390
17 Lansing St
Ste 201
Auburn, NY 13021
Phone (315) 252-7434
77 Nelson St
Ste 120
Auburn, NY 13021
Phone (315) 252-7550
5566 Jordan Rd
Elbridge, NY 13060
Phone (315) 657-3786
17 Lansing St
Sennett, NY 13021
Phone (315) 255-7011
1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488
Interoperability endpoints
- drjohnson@amms.medentdirect.com
- ajohnson@fcmg.medentdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F347820 | NY | Yes |
Addresses
Primary practice location
5566 Jordan Rd
Elbridge, NY 13060-9617
Mailing address
1001 W Fayette St Ste 400
Syracuse, NY 13204-2866
Phone (315) 937-3026
Other providers in Elbridge, NY
- Amy E Cole
- Elderchoice Inc.
- Amanda Rose Garcia
- Nicholas Scot Gilfus
- Courtney Giuffrida
- KPH Healthcare Services, Inc.
- Karin G Kroeger
- Todd H Marshall
- Maggi Mead
- Thomas William Murphy II
All providers in Elbridge, NY · Family Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.