Individual provider Active NPI

Autumn Lauren Johnson, MPAP, PA-C

  • Physician Assistant
  • Santa Ana, CA
National Provider Identifier
1457880510
Registry record updated Jun 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2650 S Bristol St Ste 101
Santa Ana, CA 92704-5751
Phone
(714) 754-1444
NPI assigned
Jun 12, 2017
Last updated
Jun 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2017

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 CA Primary

Addresses

Primary practice location

2650 S Bristol St Ste 101
Santa Ana, CA 92704-5751

Mailing address

360 Giotto
Irvine, CA 92614-8581

Other names 1

  • Autumn Lauren Purkey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20190805001561 CA Practitioner - Physician Assistant 6204163983 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HMTS IncGroup PAC ID 1951750413, 118 clinicians

Practice addresses (Care Compare)

15000 Kensington Park Dr
Suite 170
Tustin, CA 92782-1836
Phone (714) 477-8300

16205 Sand Canyon Ave
Suite 100
Irvine, CA 92618-3781
Phone (949) 557-0000

26671 Aliso Creek Rd
Suite 101
Aliso Viejo, CA 92656-4807
Phone (949) 791-3107

26672 Portola Pkwy
Suite 100
Foothill Ranch, CA 92610-1773
Phone (949) 557-0710

993 Avenida Pico
San Clemente, CA 92673-3908
Phone (949) 557-0400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54500CAMDMassage Therapist

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497225600000",
    "number": "1457880510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 GIOTTO",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926148581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 S BRISTOL ST STE 101",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927045751",
            "telephone_number": "714-754-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AUTUMN",
        "middle_name": "LAUREN",
        "name_prefix": "Mrs.",
        "credential": "MPAP, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-12",
        "last_updated": "2017-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUTUMN",
            "last_name": "PURKEY",
            "middle_name": "LAUREN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.