McKenzie Rae Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1800 E Park Ave
State College, PA 16803-6701

Phone

(814) 231-7000

NPI assigned

Apr 15, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, CA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mount Nittany Medical Center Health Services IncGroup PAC ID 8426136797, 366 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Nittany Medical Center Hospital, State College, PA, CCN 390268

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Mount Nittany Medical Center Health Services Inc

  • Internal Medicine Physician
  • State College, PA
  • NPI 1598992554
  Medicare reassignment Care Compare group NPD
• Cedar Springs Hospitalist Medical Group, Inc.

  • Hospitalist Physician
  • Glendale, CA
  • NPI 1245799279
  Medicare reassignment
• Mount Nittany Medical Center Health Services Inc

  • Pain Clinic/Center
  • State College, PA
  • NPI 1407035553
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mount Nittany Medical Center

  • Pain Clinic/Center
  • State College, PA
  • NPI 1104991801

  Hospital

  Care Compare affiliation
• Mount Nittany Medical Center

  • Clinic/Center
  • State College, PA
  • NPI 1194521302

  Hospital

  Care Compare affiliation
• Mount Nittany Medical Center

  • General Acute Care Hospital
  • State College, PA
  • NPI 1730173154
  Care Compare affiliation
• Mount Nittany Medical Center

  • Ambulatory Surgical Clinic/Center
  • State College, PA
  • NPI 1780750620

  Hospital

  Care Compare affiliation
• Mount Nittany Medical Center

  • Ambulatory Surgical Clinic/Center
  • State College, PA
  • NPI 1780752378

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1548014756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2517 EDGEWOOD DR",
            "city": "TYRONE",
            "state": "PA",
            "postal_code": "166863219",
            "telephone_number": "814-414-7681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E PARK AVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036701",
            "telephone_number": "814-231-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MCKENZIE",
        "middle_name": "RAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Ardell Johndrow, LSW
• Amanda Johnson
• Jennifer Twichell Johnson, LCSW
• Kimberly Johnson
• Matthew Ethan Johnson, PA-C
• Bruce Dalton Johnston, R.PH.
• Christopher Roser Jones, M.D.
• Emily Jones, PHARMD
• Sharon Dawn Jones
• Jamie Lynn Jordan, PHARMD

• Physician Assistant in State College, PA
• Providers in State College, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.