Individual provider Active NPI

Craig Tyrrell Johnston Jr., DO

  • Family Medicine Physician
  • Erie, PA
National Provider Identifier
1477295244
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS024777 Issued in PA
Practice address
3535 Pine Ave
Erie, PA 16504-1743
Phone
(814) 877-7260
NPI assigned
Apr 11, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 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 OT021452 PA
Family Medicine Physician 207Q00000X OS024777 PA Primary

Addresses

Primary practice location

3535 Pine Ave
Erie, PA 16504-1743

Mailing address

2421 W 36TH St
Erie, PA 16506-3565
Phone (814) 490-6351

Other practice location 1

311 W 24th St Ste 305
Erie, PA 16502-2666
Phone (814) 454-4484

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address UPMChospitals@upmcdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250717004517 PA Practitioner - Family Practice 1658887617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erie Physicians Network-Upmc,IncGroup PAC ID 1052587268, 19 clinicians

Practice addresses (Care Compare)

3535 Pine Ave
Erie, PA 16504-1743
Phone (814) 454-6057

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS024777PAMDFamily Medicine Physician
OT021452PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Erie Physicians Network-Upmc,Inc Family Medicine CurrentSince Aug 1, 2025 Accepting new patients
Saint Vincent Medical Education and Research Institute Inc PastSince Apr 1, 2022 Accepting new patients
St Vincent Medical Education and Research Institute Inc Family Medicine PastSince Apr 1, 2022 Accepting new patients

Locations

3535 Pine Ave
Ste 2
Erie, PA 16504
Phone (814) 454-3363

3535 Pine Ave
Erie, PA 16504
Phone (814) 454-3363

2 Hot Metal St
Fl 3
Pittsburgh, PA 15203
Phone (412) 432-5869

Interoperability endpoints

  • Direct secure messaging: craig.t.johnston2@upmcdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1477295244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2421 W 36TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165063565",
            "telephone_number": "814-490-6351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 PINE AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165041743",
            "telephone_number": "814-877-7260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 W 24th St Ste 305",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165022666",
            "country_code": "US",
            "telephone_number": "814-454-4484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "CRAIG",
        "middle_name": "TYRRELL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-11",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "OT021452",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS024777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UPMChospitals@upmcdirect.com",
            "affiliation": "N",
            "address_1": "600 Grant St.",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "15219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.