NATHAN JOHANSEN – Audiologist, NPI 1154215010

NATHAN JOHANSEN is a healthcare provider. based in Coeur d alene, Idaho. specializing in QUALIFIED AUDIOLOGIST. They hold a License No. 8371566 (ID). The NPI Number for NATHAN JOHANSEN is 1154215010

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
NATHAN JOHANSEN
NPI
1154215010
Phone
(509) 581-6300
Address
700 W IRONWOOD DR STE 262
Enumeration Date
5 June 2025
Last Update Date
9 October 2025

Doctor Profile

Medical School Name
UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Secondary Phone
2087654961
Graduation Year
2025 (1 year ago)
PAC ID
8527579192
Group Practice PAC ID
8426947839
Professional Enrollment ID
I20250619001925
Address ID
ID838144400CO700XXDRXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience31
Completeness85
Years active:1State licenses:1Digital endpointsOther names

82 QUALIFIED AUDIOLOGIST in ID

Provider Addresses for NATHAN JOHANSEN

  • 700 W IRONWOOD DR STE 262

    COEUR D ALENE, ID 838144400

    Phone: (509) 581-6300

    Mailing address matches the actual address.

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: 2025-06-19

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
I20250619001925IQualified AudiologistIDTBD

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 83814)

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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: 8426947839View full group profile
NameSpecialtyState
Qualified AudiologistWA
Qualified AudiologistWA
Qualified AudiologistWA
Qualified AudiologistIN
-ID

Reviews

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Frequently asked questions

Where can patients find NATHAN JOHANSEN's NPI?
You can confirm NATHAN JOHANSEN with NPI 1154215010; it appears in the national provider directory.
Is NATHAN JOHANSEN active in the national directory?
NATHAN JOHANSEN's public NPI profile is in an active state.
Does NATHAN JOHANSEN list a primary specialty?
If you are matching referrals, note Audiologist for NATHAN JOHANSEN. Clinical services aligned with this taxonomy classification.
Where is NATHAN JOHANSEN's primary listing?
We display Coeur D Alene, Idaho because that is what the record indicates for NATHAN JOHANSEN.
What if Coeur D Alene, Idaho seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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