TANISHA MARIE JOHNSON – Gerontology Nurse Practitioner, NPI 1568987873
Gerontology Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for TANISHA MARIE JOHNSON
601 Brooker Creek Blvd
Oldsmar, FL 346772962
Phone: (407) 280-9309
Fax: (855) 510-0614
Type: Location
27637 US HIGHWAY 27
LEESBURG, FL 347489033
Phone: (352) 326-6001
Fax: (352) 315-0235
Type: Location
7440, Woodland Drive, Legendary Hills, Indianapolis, Indiana, 46278, United States
INDIANAPOLIS, IN 462781720
Phone:
Type: Mailing
601, Brooker Creek Boulevard, Oldsmar, Pinellas County, Florida, 34677, United States
OLDSMAR, FL 346772962
Phone: (407) 280-9309
Fax: (855) 510-0614
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $46.
Total Amount is formed as General ($46) + Research ($0) + Ownership ($0) = $46.
Last reported payment date: 2024-12-02 • Largest payer in this snapshot: ATRICURE, INC. ($23).
Total Amount
$46
General + Research + Ownership
Payments
2
Total payment records
General Amount
$46
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-02
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ATRICURE, INC. | $23 |
| Otsuka America Pharmaceutical, Inc. | $23 |
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: 2022-04-05
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220405002005 | I | Nurse Practitioner | FL | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 34677)
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