Individual provider Active NPI

Ivy M. Johnson, PA-C

  • Surgical Physician Assistant
  • Irvine, CA
National Provider Identifier
1962553628
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA 15987 Issued in CA
Practice address
113 Waterworks Way Ste 240
Irvine, CA 92618-3175
Phone
(949) 340-9622
Fax
(949) 528-3969
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA15987 CA
Surgical Physician Assistant 363AS0400X PA 15987 CA Primary

Addresses

Primary practice location

113 Waterworks Way Ste 240
Irvine, CA 92618-3175

Mailing address

113 Waterworks Way Ste 240
Irvine, CA 92618-3175
Phone (949) 340-9622

Other names 1

  • Ms. Ivy Melissa Murphy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040907001322 CA Practitioner - Physician Assistant 4284600669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Southern California Keck School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Align Spine CenterGroup PAC ID 3375884679, 7 clinicians

Practice addresses (Care Compare)

113 Waterworks Way
Suite 240
Irvine, CA 92618-3175
Phone (949) 340-9622

Hospital & facility affiliations

  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168
  • Pih Health Hospital-Whittier Hospital, Whittier, CA, CCN 050169

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA15987CAMDPhysician Assistant
PA 15987CAMDSurgical Physician Assistant
10616MNMDFamily Nurse Practitioner
1294MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St Jude Hospital Inc Past Accepting new patients
Spine and Pain Institute of Orange County, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: imurphy888477@oc.providencedirect.org

Organizations & group practices 3

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1962553628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 WATERWORKS WAY STE 240",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183175",
            "telephone_number": "949-340-9622",
            "fax_number": "949-528-3969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 WATERWORKS WAY STE 240",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183175",
            "telephone_number": "949-340-9622",
            "fax_number": "949-528-3969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "IVY",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15987",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA 15987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IVY",
            "last_name": "MURPHY",
            "middle_name": "MELISSA",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.