Individual provider Active NPI

Kristin Johnson, PA

  • Medical Physician Assistant
  • Upper Sandusky, OH
National Provider Identifier
1487648226
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
50002299 Issued in OH
Practice address
885 N Sandusky Ave
Upper Sandusky, OH 43351-1031
Phone
(419) 294-3178
Fax
(419) 731-4271
NPI assigned
Sep 8, 2005
Last updated
Nov 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 50002299 OH Primary

Addresses

Primary practice location

885 N Sandusky Ave
Upper Sandusky, OH 43351-1031

Mailing address

885 N Sandusky Ave
Upper Sandusky, OH 43351-1031
Phone (419) 294-3178

Other identifiers 1

IdentifierTypeStateIssuer
0071599MedicaidOH

Other names 1

  • Kristin Duvuvuei Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20050727001025 OH Practitioner - Physician Assistant 0446288864 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wyandot Memorial HospitalGroup PAC ID 1557340189, 70 clinicians

Practice addresses (Care Compare)

885 N Sandusky Ave
Upper Sandusky, OH 43351-1031
Phone 41929449912157

885 N Sandusky Ave
Upper Sandusky, OH 43351-1098

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50002299OHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wyandot Memorial Hospital CurrentSince Feb 15, 2022 Accepting new patients
Wyandot Memorial Hospital CurrentSince Feb 15, 2022 Accepting new patients
Marion Physician Billing LLC Past Accepting new patients
Marion General Hospital Foundation, Inc. Past Accepting new patients
Galion Emergency Physicians Inc Past Accepting new patients

Locations

885 N Sandusky Ave
Upper Sandusky, OH 43351
Phone (419) 294-4991

Organizations & group practices 5

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": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1487648226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 N SANDUSKY AVE",
            "city": "UPPER SANDUSKY",
            "state": "OH",
            "postal_code": "433511031",
            "telephone_number": "419-294-3178",
            "fax_number": "419-731-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 N SANDUSKY AVE",
            "city": "UPPER SANDUSKY",
            "state": "OH",
            "postal_code": "433511031",
            "telephone_number": "419-294-3178",
            "fax_number": "419-731-4271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KRISTIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-08",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50002299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0071599",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "DUVUVUEI",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Upper Sandusky, OH

Sources for this page

Verify at the official NPI Registry.