Individual provider Active NPI

Brianne Lynn Johnsen, PA-C

  • Medical Physician Assistant
  • Boston, MA
National Provider Identifier
1275558652
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA00441 Issued in RI
Practice address
55 Fruit St.
Yawkey 2C
Boston, MA 02114
Phone
(617) 726-7938
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1215 TN
Physician Assistant 363A00000X 4181 MA
Medical Physician Assistant 363AM0700X PA00441 RI Primary

Addresses

Primary practice location

55 Fruit St.
Yawkey 2C
Boston, MA 02114

Mailing address

55 Fruit St.
Boston, MA 02114-2696
Phone (617) 726-7938

Other practice location 1

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-4000

Other identifiers 7

IdentifierTypeStateIssuer
1275558652OtherNPI
939025129OtherRIRI MEDICARE GROUP NUMBER
414337OtherRIBCBSRI
01/15/2008OtherRINHPRI
979005636OtherRIMEDICARE
1275558MedicaidRI
33070-7OtherRIBLUECHIP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20130703000010 MA Practitioner - Physician Assistant 8123010444 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Yale University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Hutchinson Dr
Danvers, MA 01923-3748
Phone (978) 739-6950

480 Lynnfield St
Lynn, MA 01904-1419
Phone (781) 593-3400

Hospital & facility affiliations

  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Spaulding Rehabilitation Hospital Inpatient rehabilitation facility, Charlestown, MA, CCN 223034

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1215TNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Medical Center, Inc. Current Accepting new patients
Beth Israel Lahey Health Primary Care Inc CurrentSince Jan 11, 2021 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Feb 13, 2019 Accepting new patients
Watauga Orthopaedics PLC Physician Assistant Past Accepting new patients
Tennessee Urgent Care Associates, LLC Physician Assistant Past Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
#2C
Boston, MA 02114
Phone (617) 726-7938

480 Maple St
Danvers, MA 01923
Phone (978) 304-8380

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

88 Washington St
Taunton, MA 02780
Phone (508) 828-7000

Interoperability endpoints

  • Direct secure messaging: bjohnsen159090@direct.bilh.masshiway.net
  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4
  • Direct secure messaging: johnsen.brianne.nsmc@direct.partners.masshiway.net

Organizations & group practices 8

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1275558652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST.",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-726-7938",
            "fax_number": "401-854-2519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST.",
            "address_2": "YAWKEY 2C",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-726-7938"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSEN",
        "first_name": "BRIANNE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "1215",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "4181",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "RI",
            "license": "PA00441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1275558652",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI MEDICARE GROUP NUMBER",
            "identifier": "939025129",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSRI",
            "identifier": "414337",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHPRI",
            "identifier": "01/15/2008",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "979005636",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275558",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECHIP",
            "identifier": "33070-7",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.