Individual provider Active NPI

Christy Ellyn Johnson, PA

  • Medical Physician Assistant
  • Orlando, FL
National Provider Identifier
1487902623
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9106654 Issued in FL
Practice address
303 E Par St
Orlando, FL 32804-4003
Phone
(877) 876-3627
Fax
(321) 843-4101
NPI assigned
Aug 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 9106654 FL
Medical Physician Assistant 363AM0700X PA9106654 FL Primary

Addresses

Primary practice location

303 E Par St
Orlando, FL 32804-4003

Mailing address

303 E Par St
Orlando, FL 32804-4003
Phone (877) 876-3627

Other identifiers 1

IdentifierTypeStateIssuer
100185700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20121023000784 FL Practitioner - Physician Assistant 3173773314 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

1000 W Broadway St
Oviedo, FL 32765-9260
Phone (407) 298-6950

22 W Underwood St
Orlando, FL 32806-1110
Phone (407) 648-3800

303 E Par St
Orlando, FL 32804-4003
Phone (877) 876-3627

32 W Gore St
Orlando, FL 32806-1134

52 W Underwood St
Orlando, FL 32806-1110
Phone (407) 841-5111

76 W Underwood St
Orlando, FL 32806-1110

86 W Underwood St
Orlando, FL 32806-1110
Phone (407) 896-1100

Hospital & facility affiliations

  • Orlando Health Hospital, Orlando, FL, CCN 100006
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 9106654FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Sep 27, 2012 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Mar 1, 2019 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Sep 27, 2012 Accepting new patients

Locations

587 E State Road 434
Longwood, FL 32750
Phone (407) 896-1100

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

303 E Par St
Orlando, FL 32804
Phone (321) 842-2299

1000 W Broadway St
Ste 150
Oviedo, FL 32765
Phone (407) 644-5371

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: cjohnson31024@orlandohealth.medalliesdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1345420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1487902623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E PAR ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044003",
            "telephone_number": "877-876-3627",
            "fax_number": "321-843-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E PAR ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044003",
            "telephone_number": "877-876-3627",
            "fax_number": "321-843-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHRISTY",
        "middle_name": "ELLYN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-20",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9106654",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9106654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100185700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.