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MARY LYNN JOHNSON
NPI 1003493826
Nurse Practitioner - Psychiatric/Mental Health in Boulder, CO

Active since March 26, 2021PECOS Enrolled
1505 48TH ST, BOULDER, CO 80303(303) 506-9439 Get Directions Write a Review

NPPES record last updated: July 14, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 14, 2026, Mar 26, 2021 (2 updates tracked since 2021).

About Mary Lynn Johnson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY LYNN JOHNSON (NPI 1003493826) is an individual psychiatric/mental health provider in Boulder, Colorado, licensed in Colorado (APN.1002166-NP) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2026).

NPPES Registry Identity

NPI1003493826
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameMARY LYNN JOHNSON
Location Address1505 48TH STBoulder, CO 80303-1143
Mailing Address1505 48th StBoulder, CO 80303-1143 · (303) 506-9439
Phone(303) 506-9439
Sole ProprietorYes
Medical School CMSOtherGraduated 2026
Enumeration DateMarch 26, 2021
Last NPPES UpdateJuly 14, 20262 updates tracked since enumeration
NPPES CertifiedJuly 14, 2026
✔ NPI 1003493826 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CO · APN.1002166-NP
Also ListedRegistered Nurse · Home HealthTaxonomy 163WH0200X · License 0094898 (CO)
1505 48TH ST, Boulder, CO 80303
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Lynn Johnson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4688130974
PECOS Enrollment IDI20260727004414
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Mary Johnson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Colorado In-Home Counseling
26 mi
Community/Behavioral Health
501 S CHERRY ST STE 820
Denver, CO 80246
  • Reassigned Medicare billing, Colorado enrollment
  • 76 clinicians in this Medicare group
NPI 1093220006 (702) 589-4871

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80303 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$89.43 typical visit price
range $58.06 – $174.82
Typical copayment $22.35 (range $14.51 – $43.70)
Most-billed visit code 99203
Established Patient
$102.03 typical visit price
range $18.88 – $142.79
Typical copayment $25.50 (range $4.72 – $35.69)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Johnson's NPI number?

The NPI number for Mary Johnson is 1003493826. It was assigned to this individual provider in the NPPES registry on March 26, 2021.

Where is Mary Johnson located?

Mary Johnson practices at 1505 48th St, Boulder, CO 80303. The listed phone number is (303) 506-9439.

What is Mary Johnson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Mary Johnson enrolled in Medicare?

Yes. Mary Johnson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mary Johnson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Johnson reassigns Medicare benefits to Colorado In-Home Counseling (Denver, CO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mary Johnson was last updated on July 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.