Individual provider Active NPI

Thomas M Johnson, PA-C

  • Physician Assistant
  • Erie, PA
National Provider Identifier
1063489623
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA051837 Issued in PA
Practice address
204 W 26TH St
Erie, PA 16508-1806
Phone
(814) 864-4755
Fax
(814) 864-5430
NPI assigned
Mar 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA051837 PA Primary

Addresses

Primary practice location

204 W 26TH St
Erie, PA 16508-1806

Mailing address

204 W 26TH St
Erie, PA 16508-1806
Phone (814) 864-4755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20041012000169 PA Practitioner - Physician Assistant 4789644113 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Vincent Medical Education and Research Institute IncGroup PAC ID 3870405137, 297 clinicians
Physicianspecialtynetwork PLLCGroup PAC ID 7911383567, 2 clinicians

Practice addresses (Care Compare)

155 E State St
Albion Family Practice
Albion, PA 16401-1347
Phone (814) 756-4917

204 W 26TH St
Erie, PA 16508-1806

6073 Volkman Rd
Erie, PA 16506-6501
Phone (814) 490-4445

Hospital & facility affiliations

  • Saint Vincent Hospital Hospital, Erie, PA, CCN 390009

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: tjohnson148823@direct.ahn.org

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1063489623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 W 26TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081806",
            "telephone_number": "814-864-4755",
            "fax_number": "814-864-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W 26TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081806",
            "telephone_number": "814-864-4755",
            "fax_number": "814-864-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "THOMAS",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.