Individual provider Active NPI

Dana Johnson, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1104851914
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3293 Issued in AZ
Practice address
19636 N 27TH Ave
Phoenix, AZ 85027-4013
Phone
(623) 780-1999
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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 3293 AZ Primary

Addresses

Primary practice location

19636 N 27TH Ave
Phoenix, AZ 85027-4013

Mailing address

PO Box 15070
Scottsdale, AZ 85267-5070
Phone (602) 839-6968

Other practice location 1

1300 N 12th St
Suite 301
Phoenix, AZ 85006-2848
Phone (602) 839-6968

Other practice location 2

4029 Dean Martin Dr Ste 100
Las Vegas, NV 89103-4138
Phone (702) 848-2256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20070207000290 AZ Practitioner - Physician Assistant 1052313822 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vituity - Arizona Hospitalists PCGroup PAC ID 5395163745, 70 clinicians

Practice addresses (Care Compare)

19829 N 27TH Ave
Phoenix, AZ 85027-4001
Phone (623) 879-6100

Hospital & facility affiliations

  • Honorhealth Deer Valley Medical Center Hospital, Phoenix, AZ, CCN 030092

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3293AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vituity - Arizona Hospitalists PC CurrentSince Jun 15, 2023 Accepting new patients
Cep America-Arizona, PC CurrentSince Jan 1, 2016 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Mar 1, 2014 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Mar 1, 2014 Accepting new patients
Emergency Professional Services PC Physician Assistant CurrentSince Aug 1, 2008 Accepting new patients
Arizona Post-Acute Medical Services 1 PC Past Accepting new patients

Locations

9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120

9201 W Thomas Rd
Phoenix, AZ 85037
Phone (623) 327-4000

19829 N 27th Ave
Phoenix, AZ 85027
Phone (602) 879-5720

1300 N 12th St
Ste 301
Phoenix, AZ 85006
Phone (602) 239-6968

9305 W Thomas Rd
Ste 405
Phoenix, AZ 85037
Phone (623) 327-7900

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

14502 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 214-4000

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

Organizations & group practices 11

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1104851914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15070",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852675070",
            "telephone_number": "602-839-6968",
            "fax_number": "602-839-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19636 N 27TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274013",
            "telephone_number": "623-780-1999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 N 12th St",
            "address_2": "Suite 301",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850062848",
            "country_code": "US",
            "telephone_number": "602-839-6968",
            "fax_number": "602-839-4144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4029 Dean Martin Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891034138",
            "country_code": "US",
            "telephone_number": "702-848-2256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.