TIESHA D JOHNSON PMHNP
NPI 1104082346
Nurse Practitioner - Psychiatric/Mental Health in Utica, NY

Active since August 06, 2008PECOS EnrolledAccepts Medicare Assignment
1676 SUNSET AVE, UTICA, NY 13502(315) 624-4801(315) 624-5401 Get Directions Write a Review

NPPES record last updated: December 11, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 11, 2025, Apr 11, 2025, Apr 9, 2024 and 4 more (7 updates tracked since 2018).

About Tiesha D Johnson Pmhnp NPPES

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

TIESHA D JOHNSON PMHNP (NPI 1104082346) is an individual psychiatric/mental health provider in Utica, New York, licensed in New York (401131) and active in the NPI registry since August 2008. She is enrolled in Medicare PECOS, is affiliated with Wynn Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1104082346
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameTIESHA D JOHNSONCredential: PMHNP
Location Address1676 SUNSET AVEUtica, NY 13502-5416
Mailing Address111 Hospital Dr, Attn: Credentialing DeptUtica, NY 13502 · (315) 801-8534 · Fax (315) 801-8391
Fax(315) 624-5401
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateAugust 6, 2008
Last NPPES UpdateDecember 11, 20257 updates tracked since enumeration
NPPES CertifiedDecember 11, 2025
NPI 1104082346 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses Licensed in NY · 401131 Licensed in OH · APRN.CNP.024042
1676 SUNSET AVE, Utica, NY 13502

Secondary Practice Locations 2

Location 1444 Butterfly Gardens DrColumbus, OH 43215-3427 · Phone (614) 938-0167 · Fax (614) 938-0170
Location 2700 Childrens DrColumbus, OH 43205-2639 · Phone (614) 722-4545 · Fax (614) 722-4575

Other Identifiers 1

Medicaid0384373OH

Accepted Insurance

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

Tiesha D Johnson Pmhnp 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 ID4385770478
PECOS Enrollment IDI20251219003256
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.

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $21.23 for a new patient copayment and $24.27 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 13502 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $84.93
  • Minimum New Patient Price $54.87
  • Maximum New Patient Price $166.88
  • Average New Patient Copayment $21.23
  • Minimum New Patient Copayment $13.71
  • Maximum New Patient Copayment $41.72

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $97.08
  • Minimum Established Patient Price $17.54
  • Maximum Established Patient Price $136.14
  • Average Established Patient Copayment $24.27
  • Minimum Established Patient Copayment $4.38
  • Maximum Established Patient Copayment $34.03

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Tiesha Johnson is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
WYNN HOSPITAL111 HOSPITAL DRIVE
UTICA, NY 13502
(315) 798-6000Acute Care Hospitals

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Nurse Anesthetist, Certified Registered
1676 SUNSET AVE
UTICA, NY 13502
Anesthesiology
1676 SUNSET AVE
UTICA, NY 13502
Anesthesiology
1676 SUNSET AVE
UTICA, NY 13502
Anesthesiology
1676 SUNSET AVE
UTICA, NY 13502
Nurse Anesthetist, Certified Registered
1676 SUNSET AVE
UTICA, NY 13502
Anesthesiology
1676 SUNSET AVE
UTICA, NY 13502
Nurse Anesthetist, Certified Registered
1676 SUNSET AVE
UTICA, NY 13502
Nurse Anesthetist, Certified Registered
1676 SUNSET AVE
UTICA, NY 13502
Nurse Anesthetist, Certified Registered
1676 SUNSET AVE
UTICA, NY 13502
Anesthesiology
1676 SUNSET AVE
UTICA, NY 13502
Anesthesiology
1676 SUNSET AVE
UTICA, NY 13502
Radiology (Radiation Oncology)
1676 SUNSET AVE
UTICA, NY 13502
Nurse Practitioner
1676 SUNSET AVE
UTICA, NY 13502
Psychologist
1676 SUNSET AVE
UTICA, NY 13502
Anesthesiology
1676 SUNSET AVE
UTICA, NY 13502
Emergency Medicine
1676 SUNSET AVE
UTICA, NY 13502
Speech-Language Pathologist
1676 SUNSET AVE
UTICA, NY 13502
Specialist
1676 SUNSET AVE, 4TH FLOOR
UTICA, NY 13502
Specialist
1676 SUNSET AVE, FOURTH FLOOR
UTICA, NY 13502
Speech-Language Pathologist
1676 SUNSET AVE
UTICA, NY 13502

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104082346, enumerated as an "individual" on August 06, 2008.

The provider is located at 1676 SUNSET AVE UTICA, NY 13502 and the phone number is (315) 624-4801.

Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.

The provider might be accepting Accepts: CareSource, Oscar Health Insurance, Oscar. Please consult your insurance carrier or call the provider to verify.

Tiesha Johnson is affiliated with: WYNN HOSPITAL.