MRS. SHANA JOHNSON (PA-C) – Surgical Physician Assistant, NPI 1346237492
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
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Provider Addresses for MRS. SHANA JOHNSON (PA-C)
1501, South California Avenue, Douglass Park, North Lawndale, Chicago, West Chicago Township, Cook County, Illinois, 60608, United States
CHICAGO, IL 606081732
Phone: (773) 257-6663
Type: Location
3537 PAYSPHERE CIR
CHICAGO, IL 606740035
Phone: (708) 786-2900
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $34.
Total Amount is formed as General ($34) + Research ($0) + Ownership ($0) = $34.
Last reported payment date: 2023-04-06 • Largest payer in this snapshot: ConvaTec Inc. ($34).
Total Amount
$34
General + Research + Ownership
Payments
1
Total payment records
General Amount
$34
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-04-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ConvaTec Inc. | $34 |
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: 2004-05-01
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040501000408 | I | Physician Assistant | IL | TBD |
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.
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 60608)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Cardiovascular Disease (Cardiology), Internal Medicine | IL | |
| Interventional Radiology, Diagnostic Radiology | IL | |
| Radiation Oncology, Diagnostic Radiology | IL | |
| Hematology/Oncology, Internal Medicine | IL | |
| Nurse Practitioner | IL | |
| Internal Medicine | IL | |
| Internal Medicine, Sleep Medicine | IL | |
| - | IL | |
| P A T H O L O G Y | IL | |
| General Surgery, Colorectal Surgery (Proctology) | IL |
Reviews
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