MR. DALLEN M JOHNSON (CAA. MSA) – Anesthesiologist Assistant, NPI 1629322151
Anesthesiologist Assistant
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Profile Insights
NPPES metrics only — not quality of care.
2 ANESTHESIOLOGY ASSISTANT in UT
Provider Addresses for MR. DALLEN M JOHNSON (CAA. MSA)
750 N FREEDOM BLVD
PROVO, UT 846011677
Phone:
Type: Mailing
2401 W University Ave
Muncie, IN 473033428
Phone: (765) 751-5404
Type: Location
1701 N SENATE BLVD
INDIANAPOLIS, IN 462021239
Phone: (317) 274-0275
Type: Location
250 N SHADELAND AVE
INDIANAPOLIS, IN 462194959
Phone:
Type: Mailing
3001 BROADMOOR BLVD NE
RIO RANCHO, NM 871442100
Phone: (385) 278-9148
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: 2025-04-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 5 Medicare enrollment records; no due dates published yet.
Enrollment records
5
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 |
|---|---|---|---|---|
| I20210507000165 | I | Anesthesiology Assistant | IN | TBD |
| I20231220000808 | I | Anesthesiology Assistant | UT | TBD |
| I20240724001681 | I | Anesthesiology Assistant | NM | TBD |
| I20240920001042 | I | Anesthesiology Assistant | CO | TBD |
| I20250416003614 | I | Anesthesiology 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 |
|---|---|---|---|---|
| 00731 | Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope | 20 | 20 | $0 |
| 00732 | Anesthesia for procedure on gallbladder, pancreas, or liver using an endoscope | 15 | 15 | $0 |
Insurance plans in this area (ZIP 84601)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| A N E S T H E S I O L O G Y | CO | |
| - | CO | |
| - | CO | |
| - | CO | |
| - | CO | |
| - | CO | |
| A N E S T H E S I O L O G Y | CO | |
| - | CO | |
| A N E S T H E S I O L O G Y | COLORADO | |
| A N E S T H E S I O L O G Y | OH |
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