MISS NICOLE MARIE JOHNSON PA-C
NPI 1033414248
Physician Assistant in Midvale, UT

Q: What is Nicole Johnson's NPI number?

The NPI number for Nicole Johnson is 1033414248. It was assigned to this individual provider in the NPPES registry on January 19, 2011.

Q: What is Nicole Johnson's specialty?

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

Q: Is Nicole Johnson enrolled in Medicare?

No. Nicole Johnson has opted out of Medicare through July 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Nicole Johnson was last updated on June 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.

Active since January 19, 2011Opted out of Medicare · through Jul 1, 2028

7302 S BINGHAM JUNCTION BLVD, MIDVALE, UT 84047(801) 442-5502 Get Directions Write a Review

NPPES record last updated: June 23, 2020. Verified against the NPPES registry weekly; last sync: September 20, 2026.

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About Miss Nicole Marie Johnson Pa-c NPPES

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

MISS NICOLE MARIE JOHNSON PA-C (NPI 1033414248) is an individual physician assistant in Midvale, Utah, licensed in Utah (8975784-1206) and active in the NPI registry since January 2011. She has opted out of Medicare through July 1, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1033414248

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMISS NICOLE MARIE JOHNSONCredential: PA-C

Location Address7302 S BINGHAM JUNCTION BLVDMidvale, UT 84047-4804

Mailing AddressPo Box 27128Salt Lake City, UT 84127-0128 · (801) 442-5502

Phone(801) 442-5502

Sole ProprietorYes

Enumeration DateJanuary 19, 2011

Last NPPES UpdateJune 23, 2020

NPPES CertifiedJune 23, 2020

✔ NPI 1033414248 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in UT · 8975784-1206

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.

7302 S BINGHAM JUNCTION BLVD, Midvale, UT 84047

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Miss Nicole Marie Johnson Pa-c has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2024 through July 1, 2028.

Opt-Out Effective DateJuly 1, 2024

Opt-Out In Effect ThroughJuly 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84047 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

$84.41 typical visit price

range $54.34 – $166.03

Typical copayment $21.10 (range $13.58 – $41.50)

Most-billed visit code 99203

Established Patient

$68.01 typical visit price

range $17.23 – $135.20

Typical copayment $17.00 (range $4.30 – $33.80)

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.

Other Providers at the Same Location NPPES 10

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

DR. JEFFERY L. OLSON PHARMD, BCPS

Pharmacist