CONNOR JOHNSON PA
NPI 1275401523
Physician Assistant in Boise, ID

Q: What is Connor Johnson's NPI number?

The NPI number for Connor Johnson is 1275401523. It was assigned to this individual provider in the NPPES registry on October 28, 2025.

Q: What is Connor Johnson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Connor Johnson was last updated on February 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since October 28, 2025PECOS EnrolledAccepts Medicare Assignment

190 E BANNOCK ST, BOISE, ID 83712(801) 884-7614 Get Directions Write a Review

NPPES record last updated: February 11, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Connor Johnson Pa NPPES

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

CONNOR JOHNSON PA (NPI 1275401523) is an individual physician assistant in Boise, Idaho, licensed in Idaho (2571593) and active in the NPI registry since October 2025. He is enrolled in Medicare PECOS, is affiliated with St Luke's Regional Medical Center, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1275401523

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameCONNOR JOHNSONCredential: PA

Location Address190 E BANNOCK STBoise, ID 83712-6241

Mailing Address190 E Bannock StBoise, ID 83712-6241

Phone(801) 884-7614

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateOctober 28, 2025

Last NPPES UpdateFebruary 11, 2026

NPPES CertifiedFebruary 11, 2026

✔ NPI 1275401523 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 ID · 2571593

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.

190 E BANNOCK ST, Boise, ID 83712

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Connor Johnson Pa 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.

PECOS PAC ID9133600257

PECOS Enrollment IDI20260225004383

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Luke's Regional Medical Center

Acute Care Hospitals · Boise, ID

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number130006

Location190 East Bannock StreetBoise, ID 83712 · Ada County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83712 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

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$65.77 typical visit price

range $16.68 – $130.93

Typical copayment $16.44 (range $4.17 – $32.73)

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 20

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

NORA M SUAREZ NP

Nurse Practitioner (Neonatal, Critical Care)