Individual provider Active NPI

Caitlin Johnston, PA-C

  • Physician Assistant
  • Oshkosh, WI
National Provider Identifier
1124400171
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7674 Issued in WI
Practice address
855 N Westhaven Dr
Oshkosh, WI 54904-7668
Phone
(920) 303-8700
Fax
(920) 456-7601
NPI assigned
Jun 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA181482 OR
Physician Assistant 363A00000X 085005500 IL
Physician Assistant 363A00000X 7674 WI Primary

Addresses

Primary practice location

855 N Westhaven Dr
Oshkosh, WI 54904-7668

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

3181 SW Sam Jackson Park Rd # McL586
Portland, OR 97239-3011
Phone (503) 494-8534

Other identifiers 2

IdentifierTypeStateIssuer
PA181482OtherOROREGON MEDICAL BOARD LICENSE
100260949MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cjohnston389518@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20231219001362 WI Practitioner - Physician Assistant 4284942673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Rush Medical College of Rush University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

855 N Westhaven Dr
Oshkosh, WI 54904-7668
Phone (920) 303-8700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085005500ILMDPhysician Assistant
PA181482ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Dec 29, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Dec 29, 2023 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

210 Wisconsin American Dr
Fond du Lac, WI 54937
Phone (920) 907-7000

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

855 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 451-5643

Interoperability endpoints

  • Direct secure messaging: cjohnston389518@direct.myadvocateaurora.org

Organizations & group practices 3

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": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1124400171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 N WESTHAVEN DR",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047668",
            "telephone_number": "920-303-8700",
            "fax_number": "920-456-7601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3181 SW Sam Jackson Park Rd # McL586",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393011",
            "country_code": "US",
            "telephone_number": "503-494-8534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "CAITLIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-26",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA181482",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005500",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "7674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON MEDICAL BOARD LICENSE",
            "identifier": "PA181482",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100260949",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cjohnston389518@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "855 N Westhaven Dr",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549047668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "855 N Westhaven Dr",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549047668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.