Individual provider Active NPI

Fiona Debra Johansmeyer, PA

  • Medical Physician Assistant
  • East Walpole, MA
National Provider Identifier
1871012468
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA6181 Issued in MA
Practice address
103 Providence Hwy
East Walpole, MA 02032-1512
Phone
(781) 255-0500
NPI assigned
Sep 14, 2017
Last updated
Jul 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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 PA6181 MA Primary

Addresses

Primary practice location

103 Providence Hwy
East Walpole, MA 02032-1512

Mailing address

103 Providence Hwy
East Walpole, MA 02032-1512
Phone (781) 255-0500

Other identifiers 1

IdentifierTypeStateIssuer
PA6181OtherMALICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20180118002440 MA Practitioner - Physician Assistant 6608135637 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Woonsocket Urgent Care PCGroup PAC ID 1951305168, 23 clinicians

Practice addresses (Care Compare)

1 Wrentham St
Bellingham, MA 02019-2532
Phone (508) 318-4466

103 Providence Hwy
East Walpole, MA 02032-1512
Phone (781) 255-0500

2 -4 Mercer Rd
Natick, MA 01760-2452
Phone (508) 318-4466

4 Mercer Rd
Natick, MA 01760-2415

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Woonsocket Urgent Care, PC CurrentSince Oct 13, 2023 Accepting new patients
Woonsocket Urgent Care, PC CurrentSince Oct 13, 2023 Accepting new patients

Locations

1 Wrentham St
Bellingham, MA 02019
Phone (508) 318-4466

103 Providence Hwy
East Walpole, MA 02032
Phone (781) 255-0500

2-4 Mercer Rd
Natick, MA 01760
Phone (508) 318-4466

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1871012468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 PROVIDENCE HWY",
            "city": "EAST WALPOLE",
            "state": "MA",
            "postal_code": "020321512",
            "telephone_number": "781-255-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 PROVIDENCE HWY",
            "city": "EAST WALPOLE",
            "state": "MA",
            "postal_code": "020321512",
            "telephone_number": "781-255-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSMEYER",
        "first_name": "FIONA",
        "middle_name": "DEBRA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-14",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA6181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "PA6181",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Walpole, MA

Sources for this page

Verify at the official NPI Registry.