TIESHA D JOHNSON PMHNP
NPI 1104082346
Nurse Practitioner - Psychiatric/Mental Health in Utica, NY
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
Specialties & Licenses
Secondary Practice Locations 2
Other Identifiers 1
Accepted Insurance
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
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.
Medicare Billing Reassignments
2Medicare enrollment records show Tiesha Johnson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Utica, NY 13502
- Reassigned Medicare billing, New York enrollment
- 657 clinicians in this Medicare group
Columbus, OH 43205
- Reassigned Medicare billing, Ohio enrollment
- 1,246 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.
Wynn Hospital
Acute Care Hospitals · Utica, NYPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 13502 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Tiesha Johnson's NPI number?
The NPI number for Tiesha Johnson is 1104082346. It was assigned to this individual provider in the NPPES registry on August 6, 2008.
Where is Tiesha Johnson located?
Tiesha Johnson practices at 1676 Sunset Ave, Utica, NY 13502. The listed phone number is (315) 624-4801.
What is Tiesha Johnson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Tiesha Johnson enrolled in Medicare?
Yes. Tiesha 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.
Which organizations bill Medicare for Tiesha Johnson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tiesha Johnson reassigns Medicare benefits to 2 organizations: Mvhs Inc (Utica, NY) and Pediatric Academic Association, Inc. (Columbus, OH). 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 Tiesha Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Tiesha Johnson accept?
Health plans from Antidote Health Plan of Ohio, Inc., CareSource, Oscar Health Insurance and UnitedHealthcare list Tiesha Johnson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Tiesha Johnson affiliated with any hospitals?
According to CMS data, Tiesha Johnson is affiliated with Wynn Hospital.
When was this NPI record last updated?
The NPPES record for Tiesha Johnson was last updated on December 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.
# Tiesha D Johnson, PMHNP · NPI 1104082346
Psychiatric/Mental Health physician in Utica, New York. Individual provider, active in the CMS NPPES registry since August 6, 2008.
## Identity
- **NPI:** 1104082346 (Entity type: Individual)
- **Enumerated:** August 6, 2008
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 401131 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 1676 SUNSET AVE, Utica, NY 13502-5416
- **Phone:** (315) 624-4801 · **Fax:** (315) 624-5401
## 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): Mvhs Inc (NPI 1770690737, Utica, NY); Pediatric Academic Association, Inc. (NPI 1063419943, Columbus, OH) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** December 11, 2025
- **Other identifiers:** Medicaid 0384373 (OH)
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Source: [NPI Profile](https://npiprofile.com/npi/1104082346) · Data from the CMS NPPES public registry.