Individual provider Active NPI

Alexandra Johnson, PA

  • Physician Assistant
  • Ruskin, FL
National Provider Identifier
1285463760
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9119679 Issued in FL
Practice address
948 Cypress Village Blvd Ste a
Ruskin, FL 33573-6841
Phone
(813) 633-3002
Fax
(888) 720-3963
NPI assigned
Jul 31, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA9119679 FL Primary

Addresses

Primary practice location

948 Cypress Village Blvd Ste a
Ruskin, FL 33573-6841

Mailing address

PO Box 748817
Atlanta, GA 30374-8817
Phone (813) 286-0033

Other practice location 1

1115 W Call St
Tallahassee, FL 32304-3556
Phone (850) 644-1855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20250114001062 FL Practitioner - Physician Assistant 4486182706 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Care Florida LLCGroup PAC ID 9234031444, 324 clinicians

Practice addresses (Care Compare)

946 Cypress Village Blvd
Suite B
Ruskin, FL 33573-6839
Phone (813) 633-3002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9119679FLMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: alexandra.johnson@wcfnf.eclinicaldirectplus.com

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1285463760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748817",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748817",
            "telephone_number": "813-286-0033",
            "fax_number": "813-282-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "948 CYPRESS VILLAGE BLVD STE A",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335736841",
            "telephone_number": "813-633-3002",
            "fax_number": "888-720-3963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1115 W Call St",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323043556",
            "country_code": "US",
            "telephone_number": "850-644-1855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ALEXANDRA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-31",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9119679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruskin, FL

Sources for this page

Verify at the official NPI Registry.