NIKOLENE JOHNSON – Physician Assistant, NPI 1104363993
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,678 PHYSICIAN ASSISTANT in WI
Provider Addresses for NIKOLENE JOHNSON
7920, Old Cedar Avenue South, Bloomington, Hennepin County, Minnesota, 55425, United States
BLOOMINGTON, MN 554251207
Phone: (651) 241-1800
Type: Mailing
512 S 28TH AVE
WAUSAU, WI 544014147
Phone: (715) 847-2021
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $190.
Total Amount is formed as General ($190) + Research ($0) + Ownership ($0) = $190.
Last reported payment date: 2024-09-20 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($89).
Total Amount
$190
General + Research + Ownership
Payments
6
Total payment records
General Amount
$190
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-20
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2020-05-29
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200529000031 | I | Physician Assistant | WI | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 106 | 93 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 81 | 81 | $0 |
| 69210 | Removal of impacted ear wax | 72 | 63 | $0 |
| 92504 | Exam of ear using a microscope | 43 | 33 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 31 | 31 | $0 |
Insurance plans in this area (ZIP 55425)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Allergy/Immunology, Internal Medicine | WI | |
| Physician Assistant | WI | |
| O T O L A R Y N G O L O G Y | MS | |
| O T O L A R Y N G O L O G Y | WI | |
| O T O L A R Y N G O L O G Y | WI | |
| O T O L A R Y N G O L O G Y | WI | |
| Physician Assistant | WI | |
| Qualified Audiologist | WI | |
| O T O L A R Y N G O L O G Y | WI | |
| O T O L A R Y N G O L O G Y | WI |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.