JENNIFER JOHNSON (PA-C) – Physician Assistant, NPI 1407300460

JENNIFER JOHNSON (PA-C) is a healthcare provider. based in Flagler beach, Florida. specializing in Physician Assistant. They hold the professional credentials PA-C. They hold a License No. PA9109697 (FL). The NPI Number for JENNIFER JOHNSON (PA-C) is 1407300460

Main info

Female
10 Years Of Experience
Name
JENNIFER JOHNSON (PA-C)
NPI
1407300460
Phone
Not provided
Address
1244 S OCEAN SHORE BLVD
Enumeration Date
8 August 2016
Last Update Date
25 September 2024

Doctor Profile

Medical School Name
UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE
Secondary Phone
9044506800
Graduation Year
2016 (10 years ago)
PAC ID
1557658861
Group Practice PAC ID
4183879364
Professional Enrollment ID
I20160929000964
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:9State licenses:1Digital endpointsOther names

Provider Addresses for JENNIFER JOHNSON (PA-C)

  • 1244 S OCEAN SHORE BLVD

    FLAGLER BEACH, FL 321363703

    Phone:

    Type: Mailing

  • 4 LOGGERHEAD LN

    PONTE VEDRA BEACH, FL 320822522

    Phone:

    Type: Mailing

  • 298 S YONGE ST

    ORMOND BEACH, FL 321746264

    Phone: (386) 479-2152

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $326.

Total Amount is formed as General ($326) + Research ($0) + Ownership ($0) = $326.

Last reported payment date: 2024-04-17 • Largest payer in this snapshot: Medical Device Business Services, Inc. ($256).

Total Amount

$326

General + Research + Ownership

Payments

5

Total payment records

General Amount

$326

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-17

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2016-09-29

PECOS data refreshed: 2026-05-27

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
I20160929000964IPhysician AssistantFLTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes2828$0
99214Established patient office or other outpatient visit, 30-39 minutes1413$0
99203New patient office or other outpatient visit, 30-44 minutes1212$0
View full utilization report →

Insurance plans in this area (ZIP 32136)

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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: 4183879364View full group profile
NameSpecialtyState
Nurse PractitionerFL
-FL
Nurse PractitionerFL
Family PracticeFL
-FL
Family PracticeFL
Nurse PractitionerGA
Nurse PractitionerFL
Physician AssistantFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

What is the 10-digit NPI for JENNIFER JOHNSON (PA-C)?
JENNIFER JOHNSON (PA-C) — NPI 1407300460 — is the standard way to identify this listing.
Does CMS list JENNIFER JOHNSON (PA-C) as active?
Yes — JENNIFER JOHNSON (PA-C) is active in the NPI listing used on this page.
What is JENNIFER JOHNSON (PA-C) best known for clinically?
Directory data describes JENNIFER JOHNSON (PA-C) with Physician Assistant. Clinical services aligned with this taxonomy classification.
What address line appears for JENNIFER JOHNSON (PA-C)?
JENNIFER JOHNSON (PA-C)'s geographic hint is Flagler Beach, Florida in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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