1. Home
  2. Directory
  3. Massachusetts
  4. Fitchburg
  5. Nurse Practitioner
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JOHNNY IV FNP-C
NPI 1053118950
Nurse Practitioner - Family in Fitchburg, MA

Active since February 27, 2025PECOS Enrolled
33 ELECTRIC AVE STE 102, FITCHBURG, MA 01420(978) 343-7246(978) 343-7247 Get Directions Write a Review

NPPES record last updated: September 23, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 23, 2026, May 25, 2025, Feb 27, 2025 (3 updates tracked since 2025).

About Johnny Iv Fnp-c NPPES

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

JOHNNY IV FNP-C (NPI 1053118950) is an individual family provider in Fitchburg, Massachusetts, licensed in Massachusetts (RN2351241) and active in the NPI registry since February 2025. He is enrolled in Medicare PECOS, is affiliated with Umass Memorial Healthalliance Hospitals, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1053118950
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameJOHNNY IVCredential: FNP-C
Location Address33 ELECTRIC AVE STE 102Fitchburg, MA 01420-7954
Mailing Address33 Electric Ave Ste 102Fitchburg, MA 01420-7954 · (978) 343-7246 · Fax (978) 343-7247
Phone(978) 343-7246
Fax(978) 343-7247
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateFebruary 27, 2025
Last NPPES UpdateSeptember 23, 20263 updates tracked since enumeration
NPPES CertifiedSeptember 23, 2026
✔ NPI 1053118950 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in MA · RN2351241
33 ELECTRIC AVE STE 102, Fitchburg, MA 01420
Open in Google Maps ↗

Other Identifiers 1

Medicaid110220014AMA

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

Johnny Iv Fnp-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 ID9032610498
PECOS Enrollment IDI20250828002337
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

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

Umass Memorial Healthalliance Hospitals

Acute Care Hospitals · Leominster, MA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number220001
Location60 Hospital RoadLeominster, MA 01453 · Worcester County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01420 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
$90.70 typical visit price
range $58.86 – $177.36
Typical copayment $22.67 (range $14.71 – $44.34)
Most-billed visit code 99203
Established Patient
$103.48 typical visit price
range $19.11 – $144.84
Typical copayment $25.87 (range $4.77 – $36.21)
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.

Other Providers at the Same Location NPPES 5

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

GINA DECENE NP
Nurse Practitioner (Acute Care)
33 ELECTRIC AVE STE 102
FITCHBURG, MA 01420
Worcester County (508) 363-5000
PREMIER PAIN MANAGEMENT PLLC
Pain Medicine (Interventional Pain Medicine)
33 ELECTRIC AVE STE 102
FITCHBURG, MA 01420
Worcester County (978) 343-7246
XIOMIBERTH PEREZ DE LA ROSA
Nurse Practitioner (Family)
33 ELECTRIC AVE STE 102
FITCHBURG, MA 01420
Worcester County (978) 343-7246
DR. OMAR RASHID QURESHI DO
Pain Medicine (Interventional Pain Medicine)
33 ELECTRIC AVE STE 102
FITCHBURG, MA 01420
Worcester County (978) 343-7246
PREMIER PAIN CENTERS PLLC
Anesthesiology (Pain Medicine)
33 ELECTRIC AVE STE 102
FITCHBURG, MA 01420
Worcester County (978) 343-7246

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 Johnny Iv's NPI number?

The NPI number for Johnny Iv is 1053118950. It was assigned to this individual provider in the NPPES registry on February 27, 2025.

Where is Johnny Iv located?

Johnny Iv practices at 33 Electric Ave Ste 102, Fitchburg, MA 01420. The listed phone number is (978) 343-7246.

What is Johnny Iv's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Johnny Iv enrolled in Medicare?

Yes. Johnny Iv 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 Johnny Iv affiliated with any hospitals?

According to CMS data, Johnny Iv is affiliated with Umass Memorial Healthalliance Hospitals.

When was this NPI record last updated?

The NPPES record for Johnny Iv was last updated on September 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 days 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.