NPIMap

Individual provider Active NPI

Jared M Johnson, PA

  • Physician Assistant
  • Toledo, OH
National Provider Identifier
1811048192
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2545 Issued in OH
Practice address
4235 Secor Rd
Toledo, OH 43623-4299
Phone
(419) 479-5424
Fax
(419) 479-5425
NPI assigned
Jan 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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 2545 OH Primary

Addresses

Primary practice location

4235 Secor Rd
Toledo, OH 43623-4299

Mailing address

4235 Secor Rd
Toledo, OH 43623-4299
Phone (419) 473-3561

Other practice location 1

3000 Arlington Ave
Toledo, OH 43614-2595
Phone (419) 383-3761

Other identifiers 1

IdentifierTypeStateIssuer
0074782MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20070705000670 OH Practitioner - Physician Assistant 5799885661 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Toledo Clinic IncorporatedGroup PAC ID 5698673382, 204 clinicians

Practice addresses (Care Compare)

4235 Secor Rd
Toldeo, OH 43623-4231
Phone (419) 874-3246

Hospital & facility affiliations

  • Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112
  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

Merit-based Incentive Payment System (MIPS)

Final score
88.34 of 100Reported as group
Quality
69.17
Promoting interoperability
99
Improvement activities
40
Cost
75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2545OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Toledo Clinic Incorporated CurrentSince Dec 5, 2024 Accepting new patients
Medical University of Ohio at Toledo Current Accepting new patients
Toledo Clinic Incorporated Current Accepting new patients
Toledo Clinic Incorporated CurrentSince Dec 5, 2024 Accepting new patients
University of Toledo Physicians, LLC CurrentSince Jan 1, 2012 Accepting new patients
University of Toledo Physicians LLC Physician Assistant CurrentSince Jan 1, 2012 Accepting new patients
Toledo Clinic Incorporated Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

L4189
Columbus, OH 43260

3000 Arlington Ave
Toledo, OH 43614
Phone (419) 383-3556

4235 Secor Rd
Toledo, OH 43623
Phone (419) 214-4214

3355 Glendale Ave
Toledo, OH 43614
Phone (419) 383-5614

3355 Glendale Ave
Fl 3
Toledo, OH 43614
Phone (419) 383-7100

Interoperability endpoints

  • Direct secure messaging: jjohnson25954@direct.utoledo.edu
  • FHIR API: https://api.platform.athenahealth.com/9641/brand/2/csg/1/fhir/r4

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.

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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1811048192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234299",
            "telephone_number": "419-473-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234299",
            "telephone_number": "419-479-5424",
            "fax_number": "419-479-5425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Arlington Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436142595",
            "country_code": "US",
            "telephone_number": "419-383-3761",
            "fax_number": "419-383-2933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JARED",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "2545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0074782",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.