JESSICA JOHNSON
NPI 1124633904
Physician Assistant - Medical in Colorado Springs, CO
About Jessica Johnson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JESSICA JOHNSON (NPI 1124633904) is an individual medical provider in Colorado Springs, Colorado, licensed in Colorado (PA.0006363) and active in the NPI registry since September 2020. She has opted out of Medicare through July 1, 2028 and remains eligible to order and refer and maintains a secondary practice location in Colorado Springs.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Jessica Johnson has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2026 through July 1, 2028.
Referred Medical Equipment & Supplies CMS DME claims 2
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 5
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 Jessica Johnson's NPI number?
The NPI number for Jessica Johnson is 1124633904. It was assigned to this individual provider in the NPPES registry on September 9, 2020.
Where is Jessica Johnson located?
Jessica Johnson practices at 421 S Tejon St Ste 250, Colorado Springs, CO 80903. The listed phone number is (719) 623-3068.
What is Jessica Johnson's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Jessica Johnson enrolled in Medicare?
No. Jessica Johnson has opted out of Medicare through July 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
When was this NPI record last updated?
The NPPES record for Jessica Johnson was last updated on December 23, 2022. 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.
# Jessica Johnson · NPI 1124633904
Medical physician in Colorado Springs, Colorado. Individual provider, active in the CMS NPPES registry since September 9, 2020.
## Identity
- **NPI:** 1124633904 (Entity type: Individual)
- **Enumerated:** September 9, 2020
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** PA.0006363 (Colorado)
- **Sole proprietor:** No
## Practice location
- **Address:** 421 S TEJON ST STE 250, Colorado Springs, CO 80903-2139
- **Phone:** (719) 623-3068
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through July 1, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** December 23, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1124633904) · Data from the CMS NPPES public registry.