Jennifer Johansson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

016039 Issued in NY

Practice address

235 Greenfield Pkwy
Liverpool, NY 13088-6651

Phone

(315) 452-3376

Fax

(518) 479-3794

NPI assigned

Oct 23, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Physician Assistant

Education

University of South Alabama College of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Housel Dermatology PCGroup PAC ID 4789823543, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Oswego Hospital Hospital, Oswego, NY, CCN 330218

Merit-based Incentive Payment System (MIPS)

Final score

99.57 of 100Reported as individual

Quality

99.22

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjohan@houselderm.emadirect.md

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.

• Housel Dermatology, PC

  • MOHS-Micrographic Surgery Physician
  • Liverpool, NY
  • NPI 1437597283
  Medicare reassignment Care Compare group
• Saratoga Hospital

  • Endocrinology, Diabetes & Metabolism Physician
  • Gansevoort, NY
  • NPI 1033371166
  Medicare reassignment
• Saratoga Hospital

  dba The Community Pharmacy at Saratoga Hospital

  • Community/Retail Pharmacy
  • Saratoga Springs, NY
  • NPI 1164148110
  NPD
• Saratoga Hospital

  • Urgent Care Clinic/Center
  • Queensbury, NY
  • NPI 1275177321
  NPD
• Schenectady Dermatology, PC

  • Dermatology Physician
  • Schenectady, NY
  • NPI 1417905290
  NPD (past)

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

• Oswego Hospital

  • General Acute Care Hospital
  • Oswego, NY
  • NPI 1871678458
  Care Compare affiliation

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

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1578816856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 GREENFIELD PKWY",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130886651",
            "telephone_number": "315-452-3376",
            "fax_number": "518-479-3794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 GREENFIELD PKWY",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130886651",
            "telephone_number": "315-452-3376",
            "fax_number": "518-479-3794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSSON",
        "first_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-23",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "016039",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "W34181",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AA0422",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "BA0876",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer a. Crider, LCSW, PLLC
• Jerry G. Rothrock (Liverpool Dental Center)
• Carrie Jessen
• Kathryn L Jewell, LCSW
• Joan C Laura DDS PC
• John R. Wanamaker, MD PC
• Justin T John, NP
• Elizabeth Johnson
• Helen Johnson, LMSW
• Linda Johnson, RN

• Physician Assistant in Liverpool, NY
• Providers in Liverpool, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.