Nicole Johnson, PA-C, MPH

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA56903 Issued in CA

Practice address

15004 Innovation Dr
San Diego, CA 92128-3491

Phone

(858) 605-7180

NPI assigned

Apr 22, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Scripps Green Hospital Hospital, La Jolla, CA, CCN 050424
• Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324
• Scripps Memorial Hospital - Encinitas Hospital, Encinitas, CA, CCN 050503

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Scripps Health

  • Multi-Specialty Clinic/Center
  • La Jolla, CA
  • NPI 1275899072
  Medicare reassignment Care Compare group
• Scripps Health

  • Home Health Agency
  • San Diego, CA
  • NPI 1578556114
  NPD
• Scripps Health

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841277704
  NPD
• Scripps Health

  • Family Medicine Physician
  • San Diego, CA
  • NPI 1881636108

  Physician Assistant

  NPD
• Scripps Clinic Medical Group

  • Multi-Specialty Clinic/Center
  • San Diego, CA
  • NPI 1124003280
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Scripps Health

  • General Acute Care Hospital
  • Encinitas, CA
  • NPI 1700829199
  Care Compare affiliation
• Scripps Health

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841233780
  Care Compare affiliation
• Scripps Health

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841277704
  Care Compare affiliation

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1053974360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-605-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15004 INNOVATION DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283491",
            "telephone_number": "858-605-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NICOLE",
        "credential": "PA-C, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-22",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA56903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Ray Johnson, OTC
• Michelle Lee Johnson, M.D.
• Naomi Johnson, PT, DPT
• Natalie Johnson
• Nathan D Johnson, O.D.
• Nicole Johnson
• Nicole Elizabeth Johnson, CADTP #6406
• Nicole Louise Johnson, LCSW
• Nicole Marie Johnson, OTR/L
• Nicole Nonsha Johnson

• Physician Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.