Andrew Mark Johansson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110003089 Issued in VA

Practice address

730 Thimble Shoals Blvd
Suite 130
Newport News, VA 23606-4562

Phone

(757) 873-1554

Fax

(757) 873-3239

NPI assigned

Aug 10, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Physician Assistant

Education

Eastern Virginia Medical School, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrative Regional Medical Center, PCGroup PAC ID 3577801950, 9 clinicians

Hampton Roads Orthopaedic and Sports Medicine LLCGroup PAC ID 4688659097, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ajohansson@hrosm.gwaydirect.com

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.

• Hampton Roads Orthopaedic & Sports Medicine LLC

  • Orthopaedic Surgery Physician
  • Newport News, VA
  • NPI 1790719300
  Medicare reassignment Care Compare group NPD (past)
• Integrative Regional Medical Center, P.C.

  • Nurse Practitioner
  • Mechanicsville, VA
  • NPI 1386187540
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1417189473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 THIMBLE SHOALS BLVD",
            "address_2": "SUITE 130",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064562",
            "telephone_number": "757-873-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 THIMBLE SHOALS BLVD",
            "address_2": "SUITE 130",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064562",
            "telephone_number": "757-873-1554",
            "fax_number": "757-873-3239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4030 George Washington Mem Hwy Ste B",
            "address_purpose": "LOCATION",
            "city": "Yorktown",
            "state": "VA",
            "postal_code": "236922619",
            "country_code": "US",
            "telephone_number": "757-873-1554",
            "fax_number": "757-873-3239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHANSSON",
        "first_name": "ANDREW",
        "middle_name": "MARK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-10",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110003089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "andrew.johansson@hrosm.cernerdirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "730 Thimble Shoals Blvd",
            "address_2": "Suite 130",
            "city": "Newport News",
            "state": "VA",
            "country_code": "US",
            "postal_code": "236064562",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "andrew.johansson@hrosm.cernerdirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "4030 George Washington Mem Hwy Ste B",
            "city": "Yorktown",
            "state": "VA",
            "country_code": "US",
            "postal_code": "236922619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physician Assistant in Newport News, VA
• Providers in Newport News, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.