Individual provider Active NPI

Jhalysa Johnson, FPA-P

  • Peer Specialist
  • Rochester, NY
National Provider Identifier
1649108366
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
0948 Issued in NY
Practice address
274 N Goodman St Ste D103
Rochester, NY 14607-1173
Phone
(585) 514-0653
NPI assigned
May 12, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 0948 NY Primary

Addresses

Primary practice location

274 N Goodman St Ste D103
Rochester, NY 14607-1173

Mailing address

274 N Goodman St Ste D103
Rochester, NY 14607-1173
Phone (585) 514-0653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0948NYMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1778544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1649108366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 N GOODMAN ST STE D103",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146071173",
            "telephone_number": "585-514-0653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 N GOODMAN ST STE D103",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146071173",
            "telephone_number": "585-514-0653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JHALYSA",
        "credential": "FPA-P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-12",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NY",
            "license": "0948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.