Individual provider Active NPI

Madison Kay Johnson, PA-C

  • Physician Assistant
  • Eau Claire, WI
National Provider Identifier
1285360099
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7028 Issued in WI
Practice address
1400 Bellinger Street
Eau Claire, WI 54703-5211
Phone
(715) 838-5222
NPI assigned
Jul 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 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 7028 WI Primary

Addresses

Primary practice location

1400 Bellinger Street
Eau Claire, WI 54703-5211

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (715) 838-5222

Other practice location 1

12800 N Lake Shore Dr
Mequon, WI 53097-2418
Phone (262) 243-5700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mjohnson1819130@ehrdirect.mayoclinicmsg.org

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
I20221115000620 WI Practitioner - Physician Assistant 8628446150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1221 Whipple St
Eau Claire, WI 54703-5270
Phone (715) 838-3806

1400 Bellinger St
Eau Claire, WI 54703-5222
Phone (715) 838-5222

733 W Clairemont Ave
Eau Claire, WI 54701-6101
Phone (715) 838-5222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7028WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Oct 31, 2022 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Oct 31, 2022 Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

1400 Bellinger St
Eau Claire, WI 54703
Phone (715) 838-3311

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 2

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": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1285360099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BELLINGER STREET",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547035211",
            "telephone_number": "715-838-5222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12800 N Lake Shore Dr",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530972418",
            "country_code": "US",
            "telephone_number": "262-243-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MADISON",
        "middle_name": "KAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-26",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "7028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjohnson1819130@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1400 Bellinger Street",
            "city": "Eau Claire",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547035211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

Verify at the official NPI Registry.