JOHN P JOHNSON (PA-C) – Medical Physician Assistant, NPI 1821084047

JOHN P JOHNSON (PA-C) is a healthcare provider. based in Moline, Illinois. specializing in Medical Physician Assistant. They hold the professional credentials PA-C. They hold a License No. 085002074 (IL). The NPI Number for JOHN P JOHNSON (PA-C) is 1821084047

Main info

Male
23 Years Of Experience
Accepts Medicare Assignment
Name
JOHN P JOHNSON (PA-C)
NPI
1821084047
Phone
(309) 762-0777
Address
4376 7TH ST
Enumeration Date
22 September 2005
Last Update Date
8 March 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3099445342
Graduation Year
2003 (23 years ago)
PAC ID
0042113912
Group Practice PAC ID
8729992318
Professional Enrollment ID
I20040128001009
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for JOHN P JOHNSON (PA-C)

  • 4376, 7th Street, Moline, Rock Island County, Illinois, 61265, United States

    MOLINE, IL 612656867

    Phone: (309) 762-0777

    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)

CMS reports 12 Open Payments records for all available years, with a total value of $240.

Total Amount is formed as General ($240) + Research ($0) + Ownership ($0) = $240.

Last reported payment date: 2024-12-13 • Largest payer in this snapshot: SANOFI PASTEUR INC. ($101).

Total Amount

$240

General + Research + Ownership

Payments

12

Total payment records

General Amount

$240

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-13

Latest reported date

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: 2004-01-28

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
I20040128001009IPhysician AssistantILTBD

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 61265)

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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: 8729992318View full group profile

Reviews

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Frequently asked questions

Can I verify JOHN P JOHNSON (PA-C) with an NPI only?
You can start verification with NPI 1821084047 for JOHN P JOHNSON (PA-C), then check state licensing separately.
Does CMS list JOHN P JOHNSON (PA-C) as active?
Yes — JOHN P JOHNSON (PA-C) is active in the NPI listing used on this page.
What is JOHN P JOHNSON (PA-C)'s primary classification?
Medical Physician Assistant is the headline specialty for JOHN P JOHNSON (PA-C) here. Clinical services aligned with this taxonomy classification.
What area does JOHN P JOHNSON (PA-C) serve?
JOHN P JOHNSON (PA-C)'s listing highlights Moline, Illinois; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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