KATELYN ADMIRE JOHNSON (P.A.C.) – Physician Assistant, NPI 1528684388
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,797 PHYSICIAN ASSISTANT in OK
Provider Addresses for KATELYN ADMIRE JOHNSON (P.A.C.)
1417 E 43RD PL
TULSA, OK 741054136
Phone: (757) 621-0249
Type: Mailing
2128 S ATLANTA PL
TULSA, OK 741141771
Phone: (918) 583-5131
Fax: (918) 592-0670
Type: Location
444 FOUR STATES DR
GALENA, KS 667394324
Phone: (620) 783-4441
Type: Location
1717 S Range Line Rd
Joplin, MO 648043234
Phone: (417) 556-2040
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $396.
Total Amount is formed as General ($396) + Research ($0) + Ownership ($0) = $396.
Last reported payment date: 2024-04-17 • Largest payer in this snapshot: ZIMVIE INC. ($132).
Total Amount
$396
General + Research + Ownership
Payments
4
Total payment records
General Amount
$396
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ZIMVIE INC. | $132 |
| Grifols USA, LLC | $100 |
| Intrinsic Therapeutics | $92 |
| Novartis Pharmaceuticals Corporation | $72 |
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: 2026-02-27
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20200921001504 | I | Physician Assistant | OK | TBD |
| I20260227001538 | I | Physician Assistant | KS | TBD |
| I20260227002290 | 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 |
|---|---|---|---|---|
| 63048 | Partial removal of spine bone with release of spinal cord and/or nerves, each additional segment | 23 | 15 | $0 |
| 63047 | Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment | 14 | 14 | $0 |
| 22612 | Fusion of spine in lower back | 11 | 11 | $0 |
Insurance plans in this area (ZIP 74105)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pulmonary Disease, Internal Medicine | MO | |
| Internal Medicine, Pulmonary Disease, Pulmonary Disease, Critical Care (Intensivists) | IN | |
| Physician Assistant | IL | |
| Nurse Practitioner | MO | |
| Family Practice | MO | |
| Vascular Surgery | ID | |
| - | MO | |
| Orthopedic Surgery | KS | |
| N E U R O L O G Y | MO | |
| - | MO |
Reviews
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