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COLLEEN BREEN JOHNSON PA-C
NPI 1215235429
Physician Assistant in Port Jefferson Station, NY

Active since March 11, 2011
11 MEDICAL DR, PORT JEFFERSON STATION, NY 11776(631) 509-6066 Get Directions Write a Review

NPPES record last updated: September 27, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 27, 2018, Nov 21, 2016 (2 updates tracked since 2016).

About Colleen Breen Johnson Pa-c NPPES

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

COLLEEN BREEN JOHNSON PA-C (NPI 1215235429) is an individual physician assistant in Port Jefferson Station, New York, licensed in New York (020304-1) and active in the NPI registry since March 2011.

NPPES Registry Identity

NPI1215235429
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameCOLLEEN BREEN JOHNSONCredential: PA-C
Location Address11 MEDICAL DRPort Jefferson Station, NY 11776-1589
Mailing Address120 Lebrun AveAmityville, NY 11701-4249
Phone(631) 509-6066
Sole ProprietorNo
Enumeration DateMarch 11, 2011
Last NPPES UpdateSeptember 27, 20182 updates tracked since enumeration
✔ NPI 1215235429 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Licenses✔ Licensed in NY · 020304-1✔ Licensed in NY · 020304
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.
11 MEDICAL DR, Port Jefferson Station, NY 11776
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Other Providers at the Same Location NPPES 3

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

GREGORY J DIEHL MD PC
Clinic/Center (Medical Specialty)
11 MEDICAL DR, SUITE B
PORT JEFFERSON STATION, NY 11776
Suffolk County (631) 476-7300
HOLISTIC MEDICAL WELLNESS, PLLC
Emergency Medicine
11 MEDICAL DR
PORT JEFFERSON STATION, NY 11776
Suffolk County (646) 239-1656
11 MEDICAL DRIVE WELLNESS PLLC
Emergency Medicine (Emergency Medical Services)
11 MEDICAL DR, SUITE B
PORT JEFFERSON STATION, NY 11776
Suffolk County (631) 509-6066

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 Colleen Johnson's NPI number?

The NPI number for Colleen Johnson is 1215235429. It was assigned to this individual provider in the NPPES registry on March 11, 2011.

Where is Colleen Johnson located?

Colleen Johnson practices at 11 Medical Dr, Port Jefferson Station, NY 11776. The listed phone number is (631) 509-6066.

What is Colleen Johnson's specialty?

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

When was this NPI record last updated?

The NPPES record for Colleen Johnson was last updated on September 27, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.