Derek A Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9106805 Issued in FL

Practice address

701 NW 13TH St FL 3
Boca Raton, FL 33486-2305

Phone

(561) 955-5790

Fax

(561) 955-5791

NPI assigned

Nov 15, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bocacare IncGroup PAC ID 3870633753, 196 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Boca Raton Regional Hospital Hospital, Boca Raton, FL, CCN 100168

Merit-based Incentive Payment System (MIPS)

Final score

98.99 of 100Reported as apm

Quality

81.94

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: derek.johnson.1@26289.direct.athenahealth.com

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.

• Bocacare Inc

  • Internal Medicine Physician
  • Boca Raton, FL
  • NPI 1104058940
  Medicare reassignment Care Compare group NPD
• Bocacare Inc

  • Internal Medicine Physician
  • Boynton Beach, FL
  • NPI 1225845787
  NPD
• Genesiscare USA of Florida LLC

  • Urology Physician
  • Venice, FL
  • NPI 1316127152
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Boca Raton Regional Hospital, Inc.

  • General Acute Care Hospital
  • Boca Raton, FL
  • NPI 1902826779
  Care Compare affiliation

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1962746172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 NW 13TH ST FL 3",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334862305",
            "telephone_number": "561-955-5790",
            "fax_number": "561-955-5791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 NW 13TH ST FL 3",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334862305",
            "telephone_number": "561-955-5790",
            "fax_number": "561-955-5791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DEREK",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-15",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3011968",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "398531",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01707166",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREEDOM",
            "identifier": "1039541",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4179920",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM",
            "identifier": "974430",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "IFS7Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Johnson Internal Medicine Inc
• Elizabeth Amy Johnson-Gutierrez, L.M.H.C
• Charles Robert Johnson, D.O.
• Dane Johnson
• David Michael Johnson, LMT
• Donna Lee Johnson, L.C.S.W.
• Edward Johnson, AU. D
• Elyse Jeanette Johnson
• Gabriel Johnson, P.A.
• Heather M Johnson, M.D.

• Physician Assistant in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; 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.

Verify at the official NPI Registry.