Active NPI
Amanda Jean Johnson, PA-C
- Surgical Physician Assistant
- Madison, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 2394
- Practice address
- 4621 Eastpark Blvd
Madison, WI 53718-2000 - Phone
- (608) 915-0100
- NPI assigned
- Sep 21, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 2394 | WI | Primary |
| Medical Physician Assistant | 363AM0700X | 2394-023 | WI |
Addresses
Primary practice location
4621 Eastpark Blvd
Madison, WI 53718-2000
Mailing address
7974 Uw Health CT
Middleton, WI 53562-5531
Phone (608) 260-6000
Other practice location 1
1821 S Stoughton Rd
Dean Medical Center
Madison, WI 53716-2257
Phone (608) 260-6000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679569024 | Medicaid | WI | |
| 60959 | Other | WI | DEAN HEALTH INSURANCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
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)
1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6508
4621 Eastpark Blvd
Madison, WI 53718-2000
Phone (608) 914-0100
Hospital & facility affiliations
- University of Wi Hospitals & Clinics Authority
- Mercy Health System Corp
- Borgess Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2394-023 | WI | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health System Corporation | Current | Accepting new patients | |
| University of Wisconsin Medical Foundation, Inc | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | Accepting new patients | |
| University of Wisconsin Medical Foundation, Inc | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | Accepting new patients | |
| University of Wisconsin Medical Foundation Inc | Past | Accepting new patients |
Locations
29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652
2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310
2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510
402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331
1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868
250 Doctors Ct
Johnson Creek, WI 53038
Phone (920) 699-1056
600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325
4621 Eastpark Blvd
Madison, WI 53718
Phone (608) 914-0100
1821 S Stoughton Rd
Madison, WI 53716
Phone (608) 260-6000
7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270
515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000
2977 Cty Cx
Portage, WI 53901
Phone (608) 742-3004
Interoperability endpoints
- ajohnson25375@direct.mhemail.org
Organizations & group practices 7
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.
-
- Multi-Specialty Clinic/Center
- Janesville, WI
- NPI 1598718603
-
- Multi-Specialty Clinic/Center
- Middleton, WI
- NPI 1598784555
-
- Multi-Specialty Clinic/Center
- Rockford, IL
- NPI 1043242886
-
- General Acute Care Hospital
- Janesville, WI
- NPI 1093768962
-
- Critical Access Hospital
- Lake Geneva, WI
- NPI 1699728550
-
- Health Educator
- Madison, WI
- NPI 1487414082
-
- Durable Medical Equipment & Medical Supplies
- Cross Plains, WI
- NPI 1174583363
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Janesville, WI
- NPI 1093768962
-
- General Acute Care Hospital
- Madison, WI
- NPI 1922043744
-
- General Acute Care Hospital
- Kalamazoo, MI
- NPI 1568416311
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769731200000",
"number": "1679569024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7974 UW HEALTH CT",
"city": "MIDDLETON",
"state": "WI",
"postal_code": "535625531",
"telephone_number": "608-260-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4621 EASTPARK BLVD",
"city": "MADISON",
"state": "WI",
"postal_code": "537182000",
"telephone_number": "608-915-0100"
}
],
"practiceLocations": [
{
"address_1": "1821 S Stoughton Rd",
"address_2": "Dean Medical Center",
"address_purpose": "LOCATION",
"city": "Madison",
"state": "WI",
"postal_code": "537162257",
"country_code": "US",
"telephone_number": "608-260-6000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "AMANDA",
"middle_name": "JEAN",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-21",
"last_updated": "2026-01-30",
"certification_date": "2026-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "WI",
"license": "2394",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WI",
"license": "2394-023",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1679569024",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEAN HEALTH INSURANCE",
"identifier": "60959",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2026; 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.