Individual provider Active NPI

Haley Mae Johnson, PA

  • Physician Assistant
  • New York, NY
National Provider Identifier
1386195295
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
035684 Issued in NY
Practice address
489 5TH Ave FL 3
New York, NY 10017-6145
Phone
(415) 658-6791
NPI assigned
Oct 17, 2016
Last updated
Jul 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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 035684 NY Primary
Physician Assistant 363A00000X 0010-14027 NC
Physician Assistant 363A00000X 5601007944 MI

Addresses

Primary practice location

489 5TH Ave FL 3
New York, NY 10017-6145

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Other practice location 1

6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 661-6591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161221001481 MI Practitioner - Physician Assistant 6406137942 Reassigns benefits to 7 organizations
I20240801000629 NC Practitioner - Physician Assistant 6406137942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrium Health North Market Network LLCGroup PAC ID 1557743440, 158 clinicians

Practice addresses (Care Compare)

16645 Birkdale Commons Pkwy
Suite 100
Huntersville, NC 28078-5669
Phone (704) 801-7390

20036 Zion Ave
Suite 100
Cornelius, NC 28031-8435
Phone (704) 801-7400

409 Olin Way
Suite 1200
Denver, NC 28037-9250
Phone (704) 801-7320

4525 Cameron Valley Pkwy
Suite 4100D
Charlotte, NC 28211-4369
Phone (980) 402-1800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601007944MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Medicorp Enterprises, LLC CurrentSince Sep 3, 2024 Accepting new patients
Hurley Health Services Physician Assistant CurrentSince Dec 12, 2016 Accepting new patients
Carolina Medicorp Enterprises LLC CurrentSince Sep 3, 2024 Accepting new patients
Envision Medical Group PLLC Physician Assistant CurrentSince May 7, 2018 Accepting new patients
Iha Health Services Corporation CurrentSince Nov 1, 2022 Accepting new patients
Hurley Medical Center CurrentSince Dec 12, 2016 Accepting new patients
Hometown Urgent Care of Michigan, P.C. CurrentSince Jun 12, 2023 Accepting new patients
Henry Ford Health System Physician Assistant CurrentSince Jan 1, 2026 Accepting new patients
Envision Medical Group PLLC CurrentSince May 7, 2018 Accepting new patients
Iha Health Service Corporation CurrentSince Nov 1, 2022 Accepting new patients
Hurley Medical Center Physician Assistant Current Accepting new patients
Hurley Medical Center CurrentSince Dec 12, 2016 Accepting new patients
Hurley Medical Center Physician Assistant CurrentSince Dec 12, 2016 Accepting new patients
Hometown Urgent Care of Michigan, P.C. Current Accepting new patients
Pathology Associates Inc PC Current Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 2026 Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients
Carolinas Physicians Network Inc PastSince Jun 1, 2024 Accepting new patients
Carolinas Physicians Network Inc PastSince Jun 1, 2020 Accepting new patients
Wellstreet Urgent Care of Michigan PastSince Aug 6, 2023 Accepting new patients

Locations

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

49650 Cherry Hill Rd
Ste 120
Canton, MI 48187
Phone (734) 398-7800

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

4272 W Vienna Rd
Clio, MI 48420
Phone (810) 687-2850

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

1 Hurley Plz
Flint, MI 48503
Phone (810) 257-9000

1125 S Linden Rd
Ste 210
Flint, MI 48532
Phone (810) 230-3370

1634 Gull Rd
Kalamazoo, MI 49048
Phone (269) 903-2835

42931 7 Mile Rd
Northville, MI 48167
Phone (248) 348-2442

1255 E M 36
Pinckney, MI 48169
Phone (734) 878-1000

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

620 N Pontiac Trl
Walled Lake, MI 48390
Phone (248) 624-4511

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

9550 Rocky River Rd
Ste 150
Charlotte, NC 28215
Phone (704) 457-1510

600 Highland Oaks Dr
Winston Salem, NC 27103
Phone (366) 774-0040

Interoperability endpoints

  • Direct secure messaging: hjohnson1612323@direct.novanthealth.org
  • Direct secure messaging: hjohnson2293822@direct.trinity-health.org
  • Direct secure messaging: hjohnson2900398@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 24

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 24

Hospital & facility affiliations 6

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": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1386195295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 5TH AVE FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176145",
            "telephone_number": "415-658-6791"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6777 W Maple Rd",
            "address_purpose": "LOCATION",
            "city": "West Bloomfield",
            "state": "MI",
            "postal_code": "483223013",
            "country_code": "US",
            "telephone_number": "248-661-6591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HALEY",
        "middle_name": "MAE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "035684",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-14027",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007944",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.