Individual provider Active NPI

Brooke Amanda Johnston, PA-C

  • Physician Assistant
  • Parkesburg, PA
National Provider Identifier
1134770290
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA061085 Issued in PA
Practice address
950 Octorara Trail
Parkesburg, PA 19365-2100
Phone
(610) 857-6639
Fax
(484) 334-7026
NPI assigned
Sep 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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 MA061085 PA Primary

Addresses

Primary practice location

950 Octorara Trail
Parkesburg, PA 19365-2100

Mailing address

950 Octorara Trail
Parkesburg, PA 19365-2100
Phone (610) 857-6639

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
I20191209001358 PA Practitioner - Physician Assistant 4284067034 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lancaster General Medical GroupGroup PAC ID 0941103683, 590 clinicians

Practice addresses (Care Compare)

2118 Spring Valley Rd
Lancaster, PA 17601-2427
Phone (215) 615-2222

3045 Marietta Ave
Lancaster, PA 17601-1321
Phone (717) 299-4644

51 Peters Rd
Lititz, PA 17543-7685

540 N Duke St
PM LGHP Urgent Care Duke St
Lancaster, PA 17602-2374
Phone (717) 544-6111

895 E Main St
Ephrata, PA 17522-2545

950 S Octorara Trail
Parkesburg, PA 19365-2100

950 S Octorara TRL
Parkesburg, PA 19365-2100

Hospital & facility affiliations

  • Lancaster General Hospital Hospital, Lancaster, PA, CCN 390100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster General Medical Group CurrentSince Nov 16, 2020 Accepting new patients
Lancaster General Medical Group CurrentSince Nov 16, 2020 Accepting new patients
Tower Health Medical Group CurrentSince Jan 6, 2020 Accepting new patients
Tower Health Medical Group CurrentSince Jan 6, 2020 Accepting new patients
Lancaster General Medical Group Past Accepting new patients

Locations

3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644

2118 Spring Valley Rd
Lancaster, PA 17601
Phone (215) 615-2222

950 S Octorara Trl
Parkesburg, PA 19365
Phone (610) 857-6616

301 S 7th Ave
Ste 130
West Reading, PA 19611
Phone (610) 988-4630

420 S 5th Ave
West Reading, PA 19611
Phone (484) 628-3637

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

Interoperability endpoints

  • Direct secure messaging: bpianka201453@direct-lghealth.org

Organizations & group practices 7

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 3

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": "1568937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1134770290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 OCTORARA TRAIL",
            "city": "PARKESBURG",
            "state": "PA",
            "postal_code": "193652100",
            "telephone_number": "610-857-6639",
            "fax_number": "484-334-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 OCTORARA TRAIL",
            "city": "PARKESBURG",
            "state": "PA",
            "postal_code": "193652100",
            "telephone_number": "610-857-6639",
            "fax_number": "484-334-7026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "BROOKE",
        "middle_name": "AMANDA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-20",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkesburg, PA

Sources for this page

Verify at the official NPI Registry.