Individual provider Active NPI

Deanna H Johnson, PA-C

  • Medical Physician Assistant
  • Colorado Springs, CO
National Provider Identifier
1659309631
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2243 Issued in CO
Practice address
2312 N Nevada Ave
Suite 100
Colorado Springs, CO 80907-5302
Phone
(719) 473-3272
Fax
(719) 389-1191
NPI assigned
Jun 29, 2006
Last updated
Sep 18, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2243 CO Primary

Addresses

Primary practice location

2312 N Nevada Ave
Suite 100
Colorado Springs, CO 80907-5302

Mailing address

2312 N Nevada Ave
Suite 100
Colorado Springs, CO 80907-5302
Phone (719) 473-3272

Other identifiers 1

IdentifierTypeStateIssuer
47489057MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20060824000444 CO Practitioner - Physician Assistant 5991708349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2312 N Nevada Ave
Suite 100
Colorado Springs, CO 80907-5307
Phone (719) 473-3272

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.53 of 100Reported as group
Quality
76.16
Promoting interoperability
100
Improvement activities
40
Cost
72.31

National Provider Directory

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

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1659309631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2312 N NEVADA AVE",
            "address_2": "SUITE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809075302",
            "telephone_number": "719-473-3272",
            "fax_number": "719-389-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2312 N NEVADA AVE",
            "address_2": "SUITE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809075302",
            "telephone_number": "719-473-3272",
            "fax_number": "719-389-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DEANNA",
        "middle_name": "H",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "2243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47489057",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.