Active NPI
Jaime Johnson, PA-C
- Physician Assistant
- Media, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA067205
- Practice address
- 1068 W Baltimore Pike
Media, PA 19063-5104 - Phone
- (484) 227-4280
- Fax
- (484) 227-4230
- NPI assigned
- Sep 30, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA067205 | PA | Primary |
Addresses
Primary practice location
1068 W Baltimore Pike
Media, PA 19063-5104
Mailing address
3803 W Chester Pike Ste 160
Newtown Square, PA 19073-2336
Phone (484) 227-4280
Other practice location 1
443 Laurel Oak Rd
Voorhees, NJ 08043-4419
Phone (267) 334-9933
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3803 W Chester Pike
Newtown Square, PA 19073-2336
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA067205 | PA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Main Line Healthcare | Current | Accepting new patients |
Locations
1068 W Baltimore Pike
Media, PA 19063
Phone (610) 566-9400
3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530
255 W Lancaster Ave
Ste 331
Paoli, PA 19301
Phone (484) 527-2232
100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Newtown Square, PA
- NPI 1922077643
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1759190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770595200000",
"number": "1750255097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3803 W CHESTER PIKE STE 160",
"city": "NEWTOWN SQUARE",
"state": "PA",
"postal_code": "190732336",
"telephone_number": "484-227-4280",
"fax_number": "484-227-4230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1068 W BALTIMORE PIKE",
"city": "MEDIA",
"state": "PA",
"postal_code": "190635104",
"telephone_number": "484-227-4280",
"fax_number": "484-227-4230"
}
],
"practiceLocations": [
{
"address_1": "443 Laurel Oak Rd",
"address_purpose": "LOCATION",
"city": "Voorhees",
"state": "NJ",
"postal_code": "080434419",
"country_code": "US",
"telephone_number": "267-334-9933",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "JAIME",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-09-30",
"last_updated": "2026-02-09",
"certification_date": "2026-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA067205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Media, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.