MCKENNA JOHNSON – Physical Therapist, NPI 1104400985

MCKENNA JOHNSON is a healthcare provider. based in Port allegany, Pennsylvania. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. PT028867 (PA). The NPI Number for MCKENNA JOHNSON is 1104400985

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
MCKENNA JOHNSON
NPI
1104400985
Phone
(181) 455-8731
Address
11 RANSOM STREET
Enumeration Date
8 May 2021
Last Update Date
8 May 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2026265789
Graduation Year
2020 (6 years ago)
PAC ID
5597278069
Group Practice PAC ID
0042128894
Professional Enrollment ID
I20250627002706
Address ID
DC200054155WA1330XNWXX400

Contacts

Secure Messaging
mjohnson13@upmc.edu
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness85
Years active:5State licenses:1Other namesUpdated within 12 months

4,258 PHYSICAL THERAPIST IN PRIVATE PRACTICE in PA

Provider Addresses for MCKENNA JOHNSON

  • 11 RANSOM STREET

    PORT ALLEGANY, PA 16743

    Phone: (181) 455-8731

    Type: Mailing

  • 1001 E 2ND ST

    COUDERSPORT, PA 169158161

    Phone: (814) 274-9300

    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.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-06-27

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
I20250627002706IPhysical Therapist In Private PracticeDCTBD

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 16743)

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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: 0042128894View full group profile
NameSpecialtyState
Physical Therapist In Private PracticePA
Occupational Therapist In Private PracticePA
Qualified Speech Language PathologistFL
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticePA
Occupational Therapist In Private PracticePA
Occupational Therapist In Private PracticePA
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticeDC
Physical Therapist In Private PracticeTX

Reviews

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Frequently asked questions

What federal number belongs to MCKENNA JOHNSON?
The federal identifier for MCKENNA JOHNSON is NPI 1104400985.
Is MCKENNA JOHNSON's NPI currently valid?
The extract we use shows MCKENNA JOHNSON as active.
What field does MCKENNA JOHNSON work in?
You can think of MCKENNA JOHNSON as practicing within Physical Therapist. Clinical services aligned with this taxonomy classification.
Where does public data place MCKENNA JOHNSON?
The snapshot lists Port Allegany, Pennsylvania for MCKENNA JOHNSON; download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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