NPIMap

Individual provider Active NPI

Eric Johnson, PA-C, ATC

  • Physician Assistant
  • New York, NY
National Provider Identifier
1801455100
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
535 E 70TH St
New York, NY 10021-4823
Phone
(212) 606-1000
NPI assigned
Jun 10, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

535 E 70TH St
New York, NY 10021-4823

Mailing address

170 Statesville Quarry Rd
Lafayette, NJ 07848-3129
Phone (304) 237-8511

Other practice location 1

300 Pompton Rd
Wayne, NJ 07470-2103
Phone (304) 237-8511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230608000488 NY Practitioner - Physician Assistant 3476910357 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

523 E 72 St
New York, NY 10021-4099
Phone (646) 797-8471

535 E 70TH St
New York, NY 10021-4823
Phone (646) 797-8471

Hospital & facility affiliations

  • Hospital for Special Surgery Hospital, New York, NY, CCN 330270
  • Fulton Commons Care Center Inc Nursing home, East Meadow, NY, CCN 335831

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York Society for the Relief of Ruptured & Crippled Maintaining CurrentSince May 1, 2023 Accepting new patients
Ny Society for the Relief of Ruptured & Crippled Maintaining CurrentSince Oct 23, 2023 Accepting new patients
Fulton Commons Care Center, Inc. Past Accepting new patients

Locations

535 E 70th St
New York, NY 10021

Interoperability endpoints

  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2
  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 4

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.

Hospital & facility affiliations 11

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": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1801455100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 STATESVILLE QUARRY RD",
            "city": "LAFAYETTE",
            "state": "NJ",
            "postal_code": "078483129",
            "telephone_number": "304-237-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 E 70TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214823",
            "telephone_number": "212-606-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Pompton Rd",
            "address_purpose": "LOCATION",
            "city": "Wayne",
            "state": "NJ",
            "postal_code": "074702103",
            "country_code": "US",
            "telephone_number": "304-237-8511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ERIC",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-10",
        "last_updated": "2023-06-21",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.