NPIMap

Individual provider Active NPI

Alan Paul Johnson, PA-C

  • Physician Assistant
  • St Cloud, MN
National Provider Identifier
1073824751
Registry record updated Oct 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10744 Issued in MN
Practice address
1406 6TH Avenue North
St Cloud Hospital
St Cloud, MN 56303-1901
Phone
(320) 251-2700
Fax
(320) 656-7115
NPI assigned
Jun 28, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1430 MN
Physician Assistant 363A00000X 10744 MN Primary

Addresses

Primary practice location

1406 6TH Avenue North
St Cloud Hospital
St Cloud, MN 56303-1901

Mailing address

1406 6TH Avenue North
St Cloud Hospital
St Cloud, MN 56303-1901
Phone (320) 251-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101018000216 MN Practitioner - Physician Assistant 9537060983 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke'S Hospital of DuluthGroup PAC ID 7113834839, 409 clinicians

Practice addresses (Care Compare)

1011 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7000

1015 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7860

915 E 1St St
Duluth, MN 55805-2107
Phone (218) 249-5439

Hospital & facility affiliations

  • Grand Itasca Clinic and Hospital Hospital, Grand Rapids, MN, CCN 240064
  • St Lukes Hospital Hospital, Duluth, MN, CCN 240047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1430MNMDMarriage & Family Therapist
10744MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgeview Medical Center CurrentSince Jul 26, 2021 Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Dec 1, 2021 Accepting new patients
Ridgeview Medical Center CurrentSince Jul 26, 2021 Accepting new patients
Minnesota Valley Health Center Inc CurrentSince Jul 26, 2021 Accepting new patients
County of Meeker CurrentSince Oct 19, 2020 Accepting new patients
Range Regional Health Services CurrentSince Jul 15, 2024 Accepting new patients
Sibley Medical Center CurrentSince Jul 26, 2021 Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Dec 1, 2021 Accepting new patients
Range Regional Health Services CurrentSince Jul 15, 2024 Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Apr 1, 2023 Accepting new patients
Regions Hospital CurrentSince Sep 1, 2016 Accepting new patients
County of Meeker CurrentSince Oct 19, 2020 Accepting new patients
County of Meeker Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

601 W Chandler St
Arlington, MN 55307
Phone (507) 964-2271

7907 Powers Blvd
Chanhassen, MN 55317
Phone (952) 934-0570

111 Hundertmark Rd
Ste 120
Chaska, MN 55318
Phone (952) 856-4001

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

1601 Golf Course Rd
Grand Rapids, MN 55744
Phone (218) 326-3401

111 SE 3rd St
Grand Rapids, MN 55744
Phone (218) 326-3401

750 E 34th St
Hibbing, MN 55746
Phone (218) 262-3441

621 S 4th St
Le Sueur, MN 56058
Phone (507) 665-3375

612 S Sibley Ave
Litchfield, MN 55355
Phone (320) 693-3242

402 E Platt Ave
Nashwauk, MN 55769
Phone (218) 885-2858

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

Interoperability endpoints

  • Direct secure messaging: ajohnson773560@fairview.direct-ci.com

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507766400000",
    "number": "1073824751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 6TH AVENUE NORTH",
            "address_2": "ST CLOUD HOSPITAL",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563031901",
            "telephone_number": "320-251-2700",
            "fax_number": "320-656-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 6TH AVENUE NORTH",
            "address_2": "ST CLOUD HOSPITAL",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563031901",
            "telephone_number": "320-251-2700",
            "fax_number": "320-656-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ALAN",
        "middle_name": "PAUL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-28",
        "last_updated": "2017-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "1430",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Cloud, MN

Sources for this page

Verify at the official NPI Registry.