CARLA RAE JOHNSON (CNP) – Gerontology Nurse Practitioner, NPI 1871925479
Gerontology Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,720 NURSE PRACTITIONER in MN
Provider Addresses for CARLA RAE JOHNSON (CNP)
9201 W BROADWAY AVE
SUITE 601
BROOKLYN PARK, MN 554451923
Phone: (763) 587-7974
Type: Mailing
3366 OAKDALE AVE N
SUITE 551
MINNEAPOLIS, MN 554222948
Phone: (763) 587-7737
Fax: (763) 587-7069
Type: Location
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.
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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: 2013-12-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-12-31 (891 days ago).
Enrollment records
1
Earliest due date
2023-12-31
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 |
|---|---|---|---|---|
| I20131218001679 | I | Nurse Practitioner | MN | 2023-12-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 |
|---|---|---|---|---|
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 158 | 71 | $0 |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 48 | 34 | $0 |
| G0317 | Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualifi | 47 | 32 | $0 |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 42 | 38 | $0 |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 18 | 14 | $0 |
Insurance plans in this area (ZIP 55445)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | MN | |
| Nurse Practitioner | MN | |
| Nurse Practitioner | MN | |
| - | MN | |
| General Surgery | MN | |
| Family Practice | MN | |
| Nurse Practitioner | MN | |
| - | MN | |
| Family Practice | MN | |
| Diagnostic Radiology | MN |
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