RICHARD LEE JOHNSON (PAC) – Physician Assistant, NPI 1104848555

RICHARD LEE JOHNSON (PAC) is a healthcare provider. based in Dallas, Texas. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PAC. They hold a License No. PA00053 (TX). The NPI Number for RICHARD LEE JOHNSON (PAC) is 1104848555

Main info

Male
33 Years Of Experience
Accepts Medicare Assignment
Name
RICHARD LEE JOHNSON (PAC)
NPI
1104848555
Phone
(214) 820-2505
Address
3500 GASTON AVE
Enumeration Date
24 July 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Secondary Phone
4694023400
Graduation Year
1993 (33 years ago)
PAC ID
7315126521
Group Practice PAC ID
1850729682
Professional Enrollment ID
I20110120000286
Address ID
TX750326879RO810XXPKWY501
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

8,491 PHYSICIAN ASSISTANT in TX

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Provider Addresses for RICHARD LEE JOHNSON (PAC)

  • Baylor University Medical Center, 3500, Gaston Avenue, Old East Dallas, Dallas, TX, Dallas, Dallas County, Texas, 75246, United States

    DALLAS, TX 752462017

    Phone: (214) 820-2505

    Fax: (214) 712-2487

    Type: Location

  • PO BOX 41633

    PHILADELPHIA, PA 191011633

    Phone: (800) 355-0808

    Fax: (214) 712-2487

    Type: Mailing

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: 2011-01-20

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
I20110120000286IPhysician AssistantTXTBD

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
J1100Injection, dexamethasone sodium phosphate, 1 mg21824$0
99213Established patient office or other outpatient visit, 20-29 minutes170153$0
99203New patient office or other outpatient visit, 30-44 minutes6868$0
96372Injection of drug or substance under skin or into muscle3835$0
81003Automated urinalysis test3126$0
View full utilization report →

Insurance plans in this area (ZIP 75246)

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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: 1850729682View full group profile
NameSpecialtyState
Physician AssistantTX
Nurse PractitionerIL
Physician AssistantCA
Nurse PractitionerTX
Physician AssistantTX
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Physician AssistantTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

Is there an official ID for RICHARD LEE JOHNSON (PAC) in U.S. healthcare records?
The official identifier for RICHARD LEE JOHNSON (PAC) is NPI 1104848555.
Is there an active status for RICHARD LEE JOHNSON (PAC)?
For scheduling context, RICHARD LEE JOHNSON (PAC) is shown as active in the registry.
What kind of doctor is RICHARD LEE JOHNSON (PAC)?
RICHARD LEE JOHNSON (PAC) is associated with Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with RICHARD LEE JOHNSON (PAC)?
Directory geography for RICHARD LEE JOHNSON (PAC) centers on Dallas, Texas.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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