DR. ANGELA P. JOHNSON (O.D.) – Optometrist, NPI 1073597670

DR. ANGELA P. JOHNSON (O.D.) is a healthcare provider. based in Somerset, Wisconsin. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 1993 (TN). The NPI Number for DR. ANGELA P. JOHNSON (O.D.) is 1073597670

Main info

Female
Sole Proprietor
27 Years Of Experience
Accepts Medicare Assignment
Name
DR. ANGELA P. JOHNSON (O.D.)
NPI
1073597670
Phone
(651) 270-1621
Address
247 PLUM TREE LN
Enumeration Date
6 December 2005
Last Update Date
8 August 2022

Doctor Profile

Medical School Name
SOUTHERN COLLEGE OF OPTOMETRY
Secondary Phone
6154392646
Graduation Year
1999 (27 years ago)
PAC ID
7113986977
Group Practice PAC ID
9638572944
Professional Enrollment ID
I20180626000240
Address ID
TN371282945MU1524XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness75
Years active:20State licenses:2Digital endpointsOther names

879 OPTOMETRY in MN

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Provider Addresses for DR. ANGELA P. JOHNSON (O.D.)

  • 247, Plum Tree Lane, Somerset, Saint Croix County, Wisconsin, 54025, United States

    SOMERSET, WI 540257578

    Phone: (651) 270-1621

    Fax: (651) 439-6405

    Type: Mailing

  • 13481, 60th Street North, Oak Park Heights, Washington County, Minnesota, 55082, United States

    SUITE 200

    STILLWATER, MN 550821055

    Phone: (651) 439-6400

    Fax: (651) 439-6405

    Type: Location

  • 2125 ROCK SPRINGS MIDLAND RD

    CHRISTIANA, TN 370375357

    Phone: (615) 203-9098

    Type: Mailing

  • 1524 BEASIE RD

    MURFREESBORO, TN 371282945

    Phone: (615) 439-2646

    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 $419.

Total Amount is formed as General ($419) + Research ($0) + Ownership ($0) = $419.

Last reported payment date: 2024-09-05 • Largest payer in this snapshot: Alcon Vision LLC ($261).

Total Amount

$419

General + Research + Ownership

Payments

4

Total payment records

General Amount

$419

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-05

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2018-06-26

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
I20180626000240IOptometryTNTBD

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
99213Established patient office or other outpatient visit, 20-29 minutes1612$0
View full utilization report →

Insurance plans in this area (ZIP 54025)

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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: 9638572944View full group profile
NameSpecialtyState
O P T O M E T R YTN

Reviews

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Frequently asked questions

Is there an official ID for DR. ANGELA P. JOHNSON (O.D.) in U.S. healthcare records?
The official identifier for DR. ANGELA P. JOHNSON (O.D.) is NPI 1073597670.
Active or inactive — what applies to DR. ANGELA P. JOHNSON (O.D.)?
You should see DR. ANGELA P. JOHNSON (O.D.) as active in CMS-hosted NPPES data.
What expertise is attributed to DR. ANGELA P. JOHNSON (O.D.)?
DR. ANGELA P. JOHNSON (O.D.)'s specialty line reads Optometrist. Clinical services aligned with this taxonomy classification.
Where in Wisconsin is DR. ANGELA P. JOHNSON (O.D.) registered?
Use Somerset, Wisconsin as the headline location for DR. ANGELA P. JOHNSON (O.D.) here.
Does DR. ANGELA P. JOHNSON (O.D.) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.