Brent M Johnson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601003020 Issued in MI

Practice address

5656 W US Highway 10
Ludington, MI 49431-2454

Phone

(231) 843-2543

Fax

(231) 843-2547

NPI assigned

Aug 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

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, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Health PartnersGroup PAC ID 1456430016, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Health Lakeshore Campus Hospital, Shelby, MI, CCN 231320
• Corewell Health Ludington Hospital Hospital, Ludington, MI, CCN 230110
• Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Mercy Health Partners

  • Certified Registered Nurse Anesthetist
  • Shelby, MI
  • NPI 1154910172
  Medicare reassignment Care Compare group
• Memorial Medical Center of West Michigan

  • General Acute Care Hospital
  • Ludington, MI
  • NPI 1972589489
  NPD (past)
• Mercy Health Partners

  • General Acute Care Hospital
  • Muskegon, MI
  • NPI 1831132133
  NPD (past)
• Mercy Urgent Care

  • Urgent Care Clinic/Center
  • Muskegon, MI
  • NPI 1861432692

  Physician Assistant

  NPD (past)
• Pere Marquette Emergency Physicians, PLC

  • Emergency Medicine Physician
  • Ludington, MI
  • NPI 1447284112
  NPD (past)

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

• Memorial Medical Center of West Michigan

  • General Acute Care Hospital
  • Ludington, MI
  • NPI 1972589489
  Care Compare affiliation
• Mercy Health Partners

  • Critical Access Hospital
  • Shelby, MI
  • NPI 1285662981
  Care Compare affiliation
• Mercy Health Partners

  • General Acute Care Hospital
  • Muskegon, MI
  • NPI 1831132133
  Care Compare affiliation

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

{
    "created_epoch": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1093715013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5656 W US HIGHWAY 10",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494312454",
            "telephone_number": "231-843-2543",
            "fax_number": "231-843-2547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5656 W US HIGHWAY 10",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494312454",
            "telephone_number": "231-843-2543",
            "fax_number": "231-843-2547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRENT",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-01",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CJ0662",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "5601003020",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ella Jarvis
• Marie Agnes Jensen, LMSW
• Michael Earl Jeruzal Jr., LMSW, SSW
• Lanora Kay Jewett
• Amber Johnson
• Emily Johnson
• Krista Johnson, RPH
• Mark Robert Johnson, R.PH.
• Kaitlyn Pscodna LLC
• Alicia M Kaja, LMSW

• Physician Assistant in Ludington, MI
• Providers in Ludington, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; 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.