JESSICA JOHNSON
NPI 1124633904
Physician Assistant - Medical in Colorado Springs, CO
NPI Status: Active since September 09, 2020
Contact Information
421 S TEJON ST STE 250
COLORADO SPRINGS, CO
ZIP 80903
Phone: (719) 623-3068
NPPES record last updated: December 23, 2022. Verified against the NPPES registry weekly; last sync: July 12, 2026.
Record update history: Dec 23, 2022, Sep 15, 2020, Sep 9, 2020 (3 updates tracked since 2020).
- Individual
- Female
- Physician Assistant
- Medical
- PECOS Enrolled
- Opted-Out Medicare
About JESSICA JOHNSON
This page provides the complete NPI Profile along with additional information for Jessica Johnson, a primary care provider established in Colorado Springs, Colorado with a medical specialization in Physician Assistant, focusing in medical . The healthcare provider is registered in the NPI registry with number 1124633904 assigned on September 2020. The practitioner's primary taxonomy code is 363AM0700X with license number PA.0006363 (CO). The provider is registered as an individual and her NPI record was last updated 4 years ago.
- NPI
- 1124633904
- Provider Name
- JESSICA JOHNSON
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 421 S TEJON ST STE 250 COLORADO SPRINGS, CO 80903
- Location Phone
- (719) 623-3068
- Mailing Address
- 421 S TEJON ST STE 250 COLORADO SPRINGS, CO 80903
- Mailing Phone
- (719) 623-3068
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-09-2020
- Last Update Date
- 12-23-2022
- Code Navigator
A primary care provider (PCP) like Jessica Johnson sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Jessica Johnson opted out of Medicare effective on 07-01-2026 until 07-01-2028. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Secondary Locations
- 4190 E Woodmen Rd Ste 100
Colorado Springs, CO 80920
(719) 632-4455
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant Medical
- Taxonomy Code
- 363AM0700X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- PA.0006363
- License State
- CO
Medicare Participation & PECOS Enrollment Status
Jessica Johnson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 07-01-2026
Opt-Out End Date: 07-01-2028
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
2 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Oxygen and Supplies (DC002N)
Portable oxygen concentrator, rental (HCPCS:E1392)
2 DME suppliers used 13 Medicare Claims 13 Services Paid
Reviews for JESSICA JOHNSON
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1124633904, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 56 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 5 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124633904, enumerated as an "individual" on September 09, 2020.
The provider is located at 421 S TEJON ST STE 250 COLORADO SPRINGS, CO 80903 and the phone number is (719) 623-3068.
Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.
