Peder Johnsen, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

8775 Issued in CT

Practice address

28 Crescent St
Middletown, CT 06457-3654

Phone

(860) 358-6000

NPI assigned

May 14, 2020

Last updated

Feb 24, 2021By the provider in NPPES

Sex

Male

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 CT

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

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MHS Primary Care, Inc.Group PAC ID 4082507371, shared by 4 NPIs, 180 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Middlesex Hospital Hospital, Middletown, CT, CCN 070020

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pjohnsen17882@middlesexhealthprd.direct-ci.com

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.

• MHS Primary Care Inc

  dba Middlesex Hospital Urgent Care

  • Urgent Care Clinic/Center
  • Old Saybrook, CT
  • NPI 1093138935

  Family

  Medicare reassignment NPD
• MHS Primary Care, Inc

  • Family Medicine Physician
  • Middletown, CT
  • NPI 1336279058
  Medicare reassignment NPD
• MHS Primary Care Inc

  dba Middlesex Health Concierge Medicine

  • Internal Medicine Physician
  • Essex, CT
  • NPI 1750276655
  NPD

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

• Middlesex Hospital

  • General Acute Care Hospital
  • Middletown, CT
  • NPI 1760454334
  Care Compare affiliation

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1639791577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "860-358-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "860-358-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSEN",
        "first_name": "PEDER",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-14",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "8775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Giovanna Karen Jensen
• Katherine Michelle Jimenez, LCSW
• Ted Johanson, MA
• John Dempsey Hospital at Solnit - South Campus
• Manju Mary John
• Holly Johnson
• Kaye-Loni Nichole Johnson, APRN
• Michael George Johnson Jr., M.D.
• Ronald E Johnson, MD
• Virginia B Johnson, MD

• Family Nurse Practitioner in Middletown, CT
• Providers in Middletown, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.