CLAY JOHNSON – Physician Assistant, NPI 1164021713

CLAY JOHNSON is a healthcare provider. based in Wynnewood, Pennsylvania. specializing in PHYSICIAN ASSISTANT. They hold a License No. MA061958 (PA). The NPI Number for CLAY JOHNSON is 1164021713

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
CLAY JOHNSON
NPI
1164021713
Phone
(484) 476-2000
Address
100 E Lancaster Ave
Enumeration Date
23 October 2020
Last Update Date
31 March 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9087820600
Graduation Year
2020 (6 years ago)
PAC ID
4789071564
Group Practice PAC ID
7012820574
Professional Enrollment ID
I20220426000618
Address ID
NJ088224671FL8100XDRXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:5State licenses:2Digital endpointsOther names

9,691 PHYSICIAN ASSISTANT in PA

Provider Addresses for CLAY JOHNSON

  • 100 E Lancaster Ave

    Wynnewood, PA 190963450

    Phone: (484) 476-2000

    Type: Location

  • 311 PROSSER RD

    PORTVILLE, NY 147709724

    Phone: (716) 307-1563

    Type: Mailing

  • 100 E LANCASTER AVE

    WYNNEWOOD, PA 190963450

    Phone: (484) 476-2000

    Type: Location

  • 19 RIVERHILL APT B

    NEW HOPE, PA 189381262

    Phone: (716) 307-1563

    Type: Mailing

  • 8100 WESCOTT DR

    FLEMINGTON, NJ 088224671

    Phone: (908) 264-5993

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $320.

Total Amount is formed as General ($320) + Research ($0) + Ownership ($0) = $320.

Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Stryker Corporation ($299).

Total Amount

$320

General + Research + Ownership

Payments

3

Total payment records

General Amount

$320

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-11

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Stryker Corporation$299
ABBVIE INC.$20
View all Open Payments →|Open Payments Risk Radar →

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: 2022-04-26

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220426000618IPhysician AssistantNJTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
27130Replacement of thigh bone and hip joint with prosthesis2222$0
27447Replacement of knee joint, both sides of knee1313$0
View full utilization report →

Insurance plans in this area (ZIP 19096)

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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: 7012820574View full group profile
NameSpecialtyState
Orthopedic SurgeryNJ
P O D I A T R YNJ
Physical Medicine And RehabilitationPA
Orthopedic SurgeryNJ
Orthopedic SurgeryNJ
Orthopedic SurgeryNJ
Orthopedic SurgeryNJ
Hand Surgery, Orthopedic SurgeryNY
Hand Surgery, Orthopedic SurgeryNJ
Nurse PractitionerNJ

Reviews

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Frequently asked questions

What federal number belongs to CLAY JOHNSON?
The federal identifier for CLAY JOHNSON is NPI 1164021713.
Is CLAY JOHNSON's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does CLAY JOHNSON treat or focus on?
Patients typically see CLAY JOHNSON under the specialty Physician Assistant. Clinical services aligned with this taxonomy classification.
Where is CLAY JOHNSON's primary listing?
We display Wynnewood, Pennsylvania because that is what the record indicates for CLAY JOHNSON.
What if Wynnewood, Pennsylvania seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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