AMANDA KATHLEEN JOHNSON (MD) – Pediatrics Physician, NPI 1184073421

AMANDA KATHLEEN JOHNSON (MD) is a healthcare provider. based in Newark, Delaware. specializing in PEDIATRIC MEDICINE. They hold the professional credentials MD. They hold a License No. MT210838 (PA). The NPI Number for AMANDA KATHLEEN JOHNSON (MD) is 1184073421

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA KATHLEEN JOHNSON (MD)
NPI
1184073421
Phone
(302) 733-4200
Address
4755 OGLETOWN STANTON RD
Enumeration Date
7 June 2016
Last Update Date
19 June 2019

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
2155901000
Graduation Year
2016 (10 years ago)
PAC ID
7113252685
Group Practice PAC ID
1355253527
Professional Enrollment ID
I20230601002932
Address ID
PA191044319PH3401XBLVD400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:10State licenses:2Digital endpointsOther names

178 PEDIATRIC MEDICINE in DE

Provider Addresses for AMANDA KATHLEEN JOHNSON (MD)

  • 4755 OGLETOWN STANTON RD

    NEWARK, DE 197181011

    Phone: (302) 733-4200

    Type: Location

  • 200 HYGEIA DR STE 2300

    NEWARK, DE 197132049

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-06-01

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230601002932IPediatric MedicinePATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 19718)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1355253527View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for AMANDA KATHLEEN JOHNSON (MD)?
AMANDA KATHLEEN JOHNSON (MD) — NPI 1184073421 — is the standard way to identify this listing.
Is AMANDA KATHLEEN JOHNSON (MD) still practicing?
AMANDA KATHLEEN JOHNSON (MD) is currently listed as active in the public NPI registry.
What healthcare role does AMANDA KATHLEEN JOHNSON (MD) hold?
Scheduling teams often label AMANDA KATHLEEN JOHNSON (MD) under Pediatrics Physician. Clinical services aligned with this taxonomy classification.
Does AMANDA KATHLEEN JOHNSON (MD) list a practice location?
Patients near Newark, Delaware may find AMANDA KATHLEEN JOHNSON (MD) in results; validate coverage separately.
Is the information about AMANDA KATHLEEN JOHNSON (MD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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