MARY ELIZABETH KING JOHNSON (PA-C) – Physician Assistant, NPI 1992944904
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,854 PHYSICIAN ASSISTANT in MO
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Provider Addresses for MARY ELIZABETH KING JOHNSON (PA-C)
1040, Mason Road, Fernridge, Creve Coeur, Saint Louis County, Missouri, 63141, United States
SUITE 103
SAINT LOUIS, MO 631416399
Phone: (314) 469-7246
Type: Location
1352 CULPEPPER RIDGE DR
BALLWIN, MO 630217527
Phone: (972) 898-9221
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $82.
Total Amount is formed as General ($82) + Research ($0) + Ownership ($0) = $82.
Last reported payment date: 2024-12-09 • Largest payer in this snapshot: Organogenesis Inc. ($31).
Total Amount
$82
General + Research + Ownership
Payments
5
Total payment records
General Amount
$82
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-09
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: 2010-05-26
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 |
|---|---|---|---|---|
| I20100526000012 | I | Physician Assistant | MO | 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 | 212 | 111 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 48 | 48 | $0 |
| 73564 | X-ray of knee, 4 or more views | 21 | 21 | $0 |
| 73630 | X-ray of foot, minimum of 3 views | 16 | 16 | $0 |
| 73030 | X-ray of shoulder, minimum of 2 views | 14 | 14 | $0 |
Insurance plans in this area (ZIP 63141)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Orthopedic Surgery | KY | |
| Nurse Practitioner | MO | |
| Physician Assistant | MO | |
| Physician Assistant | MO | |
| Physical Medicine And Rehabilitation | NY | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Physician Assistant | MO | |
| Nurse Practitioner | MO | |
| P O D I A T R Y | MO |
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