Miss Nicole Marie Johnson, PA-C in Midvale, UT - Medicare Physician Assistant

Miss Nicole Marie Johnson, PA-C is a medicare enrolled "Physician Assistant" in Midvale, Utah. Her current practice location is 7302 S Bingham Junction Blvd, Midvale, Utah. You can reach out to her office (for appointments etc.) via phone at (801) 442-5502.

Miss Nicole Marie Johnson is licensed to practice in Utah (license number 8975784-1206) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1033414248.

Contact Information

	Miss Nicole Marie Johnson, PA-C
	7302 S Bingham Junction Blvd, Midvale, UT 84047-4804
	(801) 442-5502
	Not Available

Provider's Profile

Full Name	Miss Nicole Marie Johnson
Gender	Female
Speciality	Physician Assistant
Location	7302 S Bingham Junction Blvd, Midvale, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1033414248
Provider Enumeration Date: 01/19/2011
Last Update Date: 06/23/2020

Medicare PECOS Information:

PECOS PAC ID: 9830353200
Enrollment ID: I20150427000805

Medical Identifiers

Medical identifiers for Miss Nicole Marie Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1033414248	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	8975784-1206 (Utah)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Miss Nicole Marie Johnson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Miss Nicole Marie Johnson, PA-C Po Box 27128, Salt Lake City, UT 84127-0128 Ph: (801) 442-5502	Miss Nicole Marie Johnson, PA-C 7302 S Bingham Junction Blvd, Midvale, UT 84047-4804 Ph: (801) 442-5502

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Mr. Mark P Pulver, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 602 Fort Union Blvd, 2nd Floor, Midvale, UT 84047 Phone: 801-313-1010 Fax: 801-747-2116
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Lynn Don Falkner, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 7495 S State St, Midvale, UT 84047 Phone: 801-213-9400
Deisy Ramirez Aguilar, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 220 W 7200 S Ste A, Midvale, UT 84047 Phone: 801-566-5494 Fax: 801-561-9647
Mr. Patrick Barde Lang, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 7495 South. State Street, Midvale, UT 84047 Phone: 801-213-9400

Miss Nicole Marie Johnson, PA-C - Medicare Physician Assistant in Midvale, UT