JOHNNY IV FNP-C
NPI 1053118950
Nurse Practitioner - Family in Fitchburg, MA
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
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignments
2Medicare enrollment records show Johnny Iv reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Fitchburg, MA 01420
- Reassigned Medicare billing, Massachusetts enrollment
- 8 clinicians in this Medicare group
Boston, MA 02215
- Reassigned Medicare billing, Massachusetts enrollment
- Also billed through NPI 1720037385 (Massachusetts)
- 2,579 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, MAPhysician 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.
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.
FITCHBURG, MA 01420
FITCHBURG, MA 01420
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.
Which organizations bill Medicare for Johnny Iv's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Johnny Iv reassigns Medicare benefits to 2 organizations: Premier Pain Management PLLC (Fitchburg, MA) and Harvard Medical Faculty Phys At Beth Israel Deaconess Med Ctr Inc (Boston, MA). Each 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 Johnny Iv's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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 27 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.
# Johnny Iv, FNP-C · NPI 1053118950
Family physician in Fitchburg, Massachusetts. Individual provider, active in the CMS NPPES registry since February 27, 2025.
## Identity
- **NPI:** 1053118950 (Entity type: Individual)
- **Enumerated:** February 27, 2025
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** RN2351241 (Massachusetts)
- **Sole proprietor:** No
## Practice location
- **Address:** 33 ELECTRIC AVE STE 102, Fitchburg, MA 01420-7954
- **Phone:** (978) 343-7246 · **Fax:** (978) 343-7247
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Premier Pain Management PLLC (NPI 1386102614, Fitchburg, MA); Harvard Medical Faculty Phys At Beth Israel Deaconess Med Ctr Inc (NPI 1194765438, Boston, MA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** September 23, 2026
- **Other identifiers:** Medicaid 110220014A (MA)
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Source: [NPI Profile](https://npiprofile.com/npi/1053118950) · Data from the CMS NPPES public registry.