MS. NICOLE A JOHNSON PA-C
NPI 1033250576
Physician Assistant in Carbondale, IL

Active since February 09, 2007PECOS EnrolledAccepts Medicare Assignment
75.73/100
CMS Quality Rating
405 W JACKSON ST, CARBONDALE, IL 62901(618) 549-0721 Get Directions Write a Review

NPPES record last updated: November 9, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 9, 2021, Aug 31, 2017 (2 updates tracked since 2017).

About Ms. Nicole A Johnson Pa-c NPPES

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

MS. NICOLE A JOHNSON PA-C (NPI 1033250576) is an individual physician assistant in Carbondale, Illinois, licensed in Illinois (085-002903) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS, is affiliated with Memorial Hospital Of Carbondale, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1033250576
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMS. NICOLE A JOHNSONCredential: PA-C
Location Address405 W JACKSON STCarbondale, IL 62901-1462
Mailing AddressPo Box 3988Carbondale, IL 62902-3988 · (618) 457-5200
Sole ProprietorYes
Medical School CMSUniversity Of Nebraska College Of MedicineGraduated 2011
Enumeration DateFebruary 9, 2007
Last NPPES UpdateNovember 9, 20212 updates tracked since enumeration
NPPES CertifiedNovember 9, 2021
NPI 1033250576 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in IL · 085-002903
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License 036-087287 (IL)
405 W JACKSON ST, Carbondale, IL 62901

Secondary Practice Locations 3

Location 18305 Express Drive, Suite CMarion, IL 62959 · Phone (618) 993-0086 · Fax (618) 993-0088
Location 22 S Hospital DrMurphysboro, IL 62966-3333 · Phone (618) 684-3156
Location 3201 S 14th StHerrin, IL 62948-3631 · Phone (618) 942-2171

Other Identifiers 1

Other085-002903IL · Pa License Number

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Ms. Nicole A Johnson Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4385714369
PECOS Enrollment IDI20080603000148
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.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Memorial Hospital Of Carbondale

Acute Care Hospitals · Carbondale, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140164
Location405 W JacksonCarbondale, IL 62901 · Jackson County
Emergency services Birthing friendly

Heartland Regional Medical Center

Acute Care Hospitals · Marion, IL
2/5 CMS rating
OwnershipProprietary
CMS Certification Number140184
Location3333 W DeyoungMarion, IL 62959 · Williamson County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62901 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75.73/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality63.09
Promoting Interoperability100
Improvement Activities40
Cost45.26

Referred Medical Equipment & Supplies CMS DME claims 7

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
2 suppliers14 claims14 services$41.79 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
6 suppliers40 claims40 services$93.51 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
5 suppliers38 claims106 services$38.61 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
6 suppliers32 claims32 services$21.02 avg. paid by Medicare
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
4 suppliers44 claims44 services$18.47 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
5 suppliers44 claims260 services$2.47 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Anesthetist, Certified Registered
405 W JACKSON ST
CARBONDALE, IL 62901
Nurse Anesthetist, Certified Registered
405 W JACKSON ST
CARBONDALE, IL 62901
Nurse Anesthetist, Certified Registered
405 W JACKSON ST
CARBONDALE, IL 62901
Anesthesiology
405 W JACKSON ST, MEMORIAL HOSPITAL OF CARBONDALE
CARBONDALE, IL 62901
Occupational Therapist
405 W JACKSON ST
CARBONDALE, IL 62901
Physical Therapist
405 W JACKSON ST
CARBONDALE, IL 62901
Physical Therapist
405 W JACKSON ST
CARBONDALE, IL 62901
Speech-Language Pathologist
405 W JACKSON ST
CARBONDALE, IL 62901

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 Nicole Johnson's NPI number?

The NPI number for Nicole Johnson is 1033250576. It was assigned to this individual provider in the NPPES registry on February 9, 2007.

Where is Nicole Johnson located?

Nicole Johnson practices at 405 W Jackson St, Carbondale, IL 62901. The listed phone number is (618) 549-0721.

What is Nicole Johnson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Nicole Johnson enrolled in Medicare?

Yes. Nicole Johnson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Nicole Johnson affiliated with any hospitals?

According to CMS data, Nicole Johnson is affiliated with Memorial Hospital Of Carbondale and Heartland Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Nicole Johnson was last updated on November 9, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.