Individual provider Active NPI

Angila Murray Johnson, P.A.

  • Physician Assistant
  • Salem, OR
National Provider Identifier
1649473349
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01355 Issued in OR
Practice address
665 Winter St SE
Post Office Box 14001
Salem, OR 97301-3919
Phone
(503) 561-2448
Fax
(503) 561-4759
NPI assigned
Jun 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA01355 OR
Physician Assistant 363A00000X PA01355 OR Primary

Addresses

Primary practice location

665 Winter St SE
Post Office Box 14001
Salem, OR 97301-3919

Mailing address

665 Winter St SE
Post Office Box 14001
Salem, OR 97301-3919
Phone (503) 561-2448

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20080730000225 OR Practitioner - Physician Assistant 1254405905 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.41 of 100Reported as group
Quality
88.83
Promoting interoperability
100
Improvement activities
40
Cost
82.4

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA01355ORMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Santiam Memorial Hospital CurrentSince Nov 26, 2017 Accepting new patients
Silverton Health CurrentSince Apr 18, 2024 Accepting new patients
Silverton Health CurrentSince Apr 18, 2024 Accepting new patients
Santiam Memorial Hospital CurrentSince Nov 26, 2017 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince May 13, 2015 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince May 13, 2015 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660

347 Fairview St
Silverton, OR 97381
Phone (503) 873-5667

1375 N 10th Ave
Ste B
Stayton, OR 97383
Phone (503) 769-7546

Interoperability endpoints

  • Direct secure messaging: ajohnson@santiam.securechart.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1649473349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 WINTER ST SE",
            "address_2": "POST OFFICE BOX 14001",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013919",
            "telephone_number": "503-561-2448",
            "fax_number": "503-561-4759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 WINTER ST SE",
            "address_2": "POST OFFICE BOX 14001",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013919",
            "telephone_number": "503-561-2448",
            "fax_number": "503-561-4759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANGILA",
        "middle_name": "MURRAY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-08",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA01355",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.