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DELISHA M JOHNSON PAC
NPI 1114030566
Physician Assistant in Port Orchard, WA

Active since August 17, 2006PECOS Enrolled
320 S KITSAP BLVD, PORT ORCHARD, WA 98366(360) 876-7215(360) 876-6721 Get Directions Write a Review

NPPES record last updated: February 9, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Delisha M Johnson Pac NPPES

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

DELISHA M JOHNSON PAC (NPI 1114030566) is an individual physician assistant in Port Orchard, Washington, licensed in Washington (PA10004048) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114030566
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameDELISHA M JOHNSONCredential: PAC
Location Address320 S KITSAP BLVDPort Orchard, WA 98366-3778
Mailing AddressPo Box 960Bremerton, WA 98337 · (360) 478-2366 · Fax (360) 373-2096
Phone(360) 876-7215
Fax(360) 876-6721
Sole ProprietorNo
Enumeration DateAugust 17, 2006
Last NPPES UpdateFebruary 9, 2011
✔ NPI 1114030566 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in WA · PA10004048
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
320 S KITSAP BLVD, Port Orchard, WA 98366
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Other Names 1

Former Name (1)Delisha Durham Pac

Other Identifiers 2

Medicaid8321150WA
Medicare UPINP54975

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Delisha M Johnson Pac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 CMS claims · ZIP area

Typical Medicare office-visit costs in the 98366 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
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$71.29 typical visit price
range $18.56 – $141.11
Typical copayment $17.82 (range $4.64 – $35.27)
Most-billed visit code 99213
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 18

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

PENINSULA COMMUNITY HEALTH SERVICES
Clinic/Center (Federally Qualified Health Center (FQHC))
320 S KITSAP BLVD
PORT ORCHARD, WA 98366
Kitsap County (360) 377-3776
ALEKSANDR ANATOLYEVICH KASYANCHUK
Nurse Practitioner (Psychiatric/Mental Health)
320 S KITSAP BLVD
PORT ORCHARD, WA 98366
Kitsap County (360) 377-3776
PENINSULA COMMUNITY HEALTH SERVICES
Clinic/Center (Federally Qualified Health Center (FQHC))
320 S KITSAP BLVD
PORT ORCHARD, WA 98366
Kitsap County (360) 377-3776
DR. ANN BRIDGES BRUCE MD
Psychiatry & Neurology (Psychiatry)
320 S KITSAP BLVD
PORT ORCHARD, WA 98366
Kitsap County (360) 377-3776
CLAUDIA C SLOAN M.D.
Family Medicine
320 S KITSAP BLVD
PORT ORCHARD, WA 98366
Kitsap County (360) 377-3776
ELIZABETH WHITESIDE PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
320 S KITSAP BLVD
PORT ORCHARD, WA 98366
Kitsap County (360) 377-3776
COLLEEN C WILLIAMS MN
Nurse Practitioner (Psychiatric/Mental Health)
320 S KITSAP BLVD
PORT ORCHARD, WA 98366
Kitsap County (360) 377-3776
CLEMENT PHUONG NGUYEN LE THANH
Pediatrics
320 S KITSAP BLVD
PORT ORCHARD, WA 98366
Kitsap County (360) 876-7215

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 Delisha Johnson's NPI number?

The NPI number for Delisha Johnson is 1114030566. It was assigned to this individual provider in the NPPES registry on August 17, 2006. The provider is also known as Delisha Durham Pac.

Where is Delisha Johnson located?

Delisha Johnson practices at 320 S Kitsap Blvd, Port Orchard, WA 98366. The listed phone number is (360) 876-7215.

What is Delisha Johnson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Delisha Johnson enrolled in Medicare?

Yes. Delisha Johnson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Delisha Johnson was last updated on February 9, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.