KEITON JOHNSON (PA-C) – Family Medicine Physician, NPI 1851903702

KEITON JOHNSON (PA-C) is a healthcare provider. based in Idaho falls, Idaho. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA-1920 (ID). The NPI Number for KEITON JOHNSON (PA-C) is 1851903702

Main info

Male
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
KEITON JOHNSON (PA-C)
NPI
1851903702
Phone
(208) 528-8170
Address
3425 POTOMAC WAY
Enumeration Date
21 August 2020
Last Update Date
24 May 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2082271100
Graduation Year
2020 (6 years ago)
PAC ID
8022436914
Group Practice PAC ID
6204731227
Professional Enrollment ID
I20200909001209
Address ID
ID834044720ID3720XDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

1,531 PHYSICIAN ASSISTANT in ID

Provider Addresses for KEITON JOHNSON (PA-C)

  • 3425 POTOMAC WAY

    IDAHO FALLS, ID 834044984

    Phone: (208) 528-8170

    Type: Mailing

  • 2659 E 105 N

    IDAHO FALLS, ID 834015441

    Phone: (208) 716-5083

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 99 Open Payments records for all available years, with a total value of $1,894.

Total Amount is formed as General ($1,894) + Research ($0) + Ownership ($0) = $1,894.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($551).

Total Amount

$1,894

General + Research + Ownership

Payments

99

Total payment records

General Amount

$1,894

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

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: 2020-09-09

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
I20200909001209IPhysician AssistantIDTBD

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 minutes433206$0
36415Insertion of needle into vein for collection of blood sample166135$0
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count142126$0
83036Hemoglobin a1c level127116$0
80053Blood test, comprehensive group of blood chemicals126110$0
View full utilization report →

Insurance plans in this area (ZIP 83404)

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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: 6204731227View full group profile
NameSpecialtyState
Plastic And Reconstructive SurgeryMD
Orthopedic SurgeryID
Physician AssistantID
Orthopedic SurgeryUT
Physician AssistantID
-ID
-ID
Orthopedic SurgeryOH
Orthopedic SurgeryID
Physician AssistantAZ

Reviews

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Frequently asked questions

What is the registry number for KEITON JOHNSON (PA-C)?
The registry entry for KEITON JOHNSON (PA-C) shows NPI 1851903702.
Is KEITON JOHNSON (PA-C) currently accepting referrals based on NPI status?
Registry metadata lists KEITON JOHNSON (PA-C) as active.
What type of care does KEITON JOHNSON (PA-C) provide?
KEITON JOHNSON (PA-C)'s profile centers on Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to KEITON JOHNSON (PA-C)?
KEITON JOHNSON (PA-C) is associated with Idaho Falls, Idaho in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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