Bryan R Johnson, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9110858 Issued in FL

Practice address

6716 NW 11TH PL Ste 200
Gainesville, FL 32605-4201

Phone

(352) 331-9729

Fax

(352) 331-0136

NPI assigned

Jan 25, 2018

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 4

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Doctors Radiology Group of Gainesville LLCGroup PAC ID 4789692328, 33 clinicians

Doctors Imaging Group LLCGroup PAC ID 3476457862, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida North Florida Hospital Hospital, Gainesville, FL, CCN 100204
• HCA Florida Lake City Hospital Hospital, Lake City, FL, CCN 100156

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Doctors Imaging Group LLC

  • Diagnostic Radiology Physician
  • Gainesville, FL
  • NPI 1134179989
  Medicare reassignment Care Compare group
• Doctors Radiology Group of Gainesville LLC

  • Diagnostic Radiology Physician
  • Gainesville, FL
  • NPI 1194775783
  Medicare reassignment Care Compare group

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

• North Florida Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Gainesville, FL
  • NPI 1174579155
  Care Compare affiliation
• Notami Hospitals of Florida Inc

  • General Acute Care Hospital
  • Lake City, FL
  • NPI 1992751879
  Care Compare affiliation

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

{
    "created_epoch": "1516838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1992203830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6716 NW 11TH PL STE 200",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6716 NW 11TH PL STE 200",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054201",
            "telephone_number": "352-331-9729",
            "fax_number": "352-331-0136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRYAN",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-25",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9110858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "FP1NC",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0237411-00",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "JF178Y",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "JG187Z",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Annette E Johnson
• Anthony Lorne Johnson, LMT
• Ashley Johnson
• Benjamin Reid Johnson
• Brianna Johnson
• Camille Johnson
• Catheryn Yvette Johnson, OTR
• Chonce T Johnson
• Cletus Johnson
• Debra Johnson

• Medical Physician Assistant in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.