MS. STACY ANN JOHNSON R.N.
NPI 1083967616
Nurse Practitioner - Adult Health in Rochester, NY

Active since October 19, 2012PECOS EnrolledAccepts Medicare Assignment
95.19/100
CMS Quality Rating
1415 PORTLAND AVE STE 200, ROCHESTER, NY 14621(585) 922-0390(585) 922-0395 Get Directions Write a Review

NPPES record last updated: February 1, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 1, 2023, Jan 6, 2023, Jun 8, 2021 (3 updates tracked since 2021).

About Ms. Stacy Ann Johnson R.n. NPPES

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

MS. STACY ANN JOHNSON R.N. (NPI 1083967616) is an individual adult health provider in Rochester, New York, licensed in New York (309651) and active in the NPI registry since October 2012. She is enrolled in Medicare PECOS, is affiliated with Clifton Springs Hospital And Clinic, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1083967616
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameMS. STACY ANN JOHNSONCredential: R.N.
Location Address1415 PORTLAND AVE STE 200Rochester, NY 14621-3022
Mailing Address100 Kings Hwy SRochester, NY 14617-5504 · (585) 368-4050 · Fax (585) 723-6705
Fax(585) 922-0395
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateOctober 19, 2012
Last NPPES UpdateFebruary 1, 20233 updates tracked since enumeration
NPPES CertifiedFebruary 1, 2023
NPI 1083967616 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License Licensed in NY · 309651
Also ListedRegistered NurseTaxonomy 163W00000X · License 577104 (NY)
1415 PORTLAND AVE STE 200, Rochester, NY 14621

Secondary Practice Locations 2

Location 1105 Canal Landing Blvd Ste 1Rochester, NY 14626-5107 · Phone (585) 368-4050 · Fax (585) 723-6705
Location 2300 Crosman TerRochester, NY 14620-1822 · Phone (585) 773-1849

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. Stacy Ann Johnson R.n. 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 ID7618379561
PECOS Enrollment IDI20210714002360
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.

Clifton Springs Hospital And Clinic

Acute Care Hospitals · Clifton Springs, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330265
Location2 Coulter RoadClifton Springs, NY 14432 · Ontario County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14621 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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.

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.

95.19/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality70.62
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 13

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

Internal Medicine (Geriatric Medicine)
1415 PORTLAND AVE STE 200
ROCHESTER, NY 14621
Nurse Practitioner (Family)
1415 PORTLAND AVE STE 200
ROCHESTER, NY 14621
Nurse Practitioner (Gerontology)
1415 PORTLAND AVE STE 200
ROCHESTER, NY 14621
Nurse Practitioner (Acute Care)
1415 PORTLAND AVE STE 200
ROCHESTER, NY 14621
Family Medicine (Geriatric Medicine)
1415 PORTLAND AVE STE 200
ROCHESTER, NY 14621
Nurse Practitioner (Adult Health)
1415 PORTLAND AVE STE 200
ROCHESTER, NY 14621
Nurse Practitioner (Gerontology)
1415 PORTLAND AVE STE 200
ROCHESTER, NY 14621
Nurse Practitioner (Adult Health)
1415 PORTLAND AVE STE 200
ROCHESTER, NY 14621

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 Stacy Johnson's NPI number?

The NPI number for Stacy Johnson is 1083967616. It was assigned to this individual provider in the NPPES registry on October 19, 2012.

Where is Stacy Johnson located?

Stacy Johnson practices at 1415 Portland Ave Ste 200, Rochester, NY 14621. The listed phone number is (585) 922-0390.

What is Stacy Johnson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Stacy Johnson enrolled in Medicare?

Yes. Stacy 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 Stacy Johnson affiliated with any hospitals?

According to CMS data, Stacy Johnson is affiliated with Clifton Springs Hospital And Clinic.

When was this NPI record last updated?

The NPPES record for Stacy Johnson was last updated on February 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.