AMANDA C. JOHNSON M.D.
NPI 1285995589
Pediatrics - Pediatric Critical Care Medicine in Worcester, MA

Q: What is Amanda Johnson's NPI number?

The NPI number for Amanda Johnson is 1285995589. It was assigned to this individual provider in the NPPES registry on June 4, 2012.

Q: What is Amanda Johnson's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Q: When was this NPI record last updated?

The NPPES record for Amanda Johnson was last updated on November 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since June 04, 2012PECOS Enrolled

55 LAKE AVE N, WORCESTER, MA 01655(774) 442-2164(774) 443-2062 Get Directions Write a Review

NPPES record last updated: November 10, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 10, 2020, Jun 13, 2019 (2 updates tracked since 2019).

On this page

About Amanda C. Johnson M.d. NPPES

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

AMANDA C. JOHNSON M.D. (NPI 1285995589) is an individual pediatric critical care medicine provider in Worcester, Massachusetts, licensed in Massachusetts (262592) and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1285995589

Entity TypeIndividualFemale

Primary Taxonomy2080P0203X

Provider Legal NameAMANDA C. JOHNSONCredential: M.D.

Location Address55 LAKE AVE NWorcester, MA 01655-0002

Mailing AddressPo Box 415348Boston, MA 02241-5348 · (800) 225-8885 · Fax (508) 334-1977

Phone(774) 442-2164

Fax(774) 443-2062

Sole ProprietorNo

Enumeration DateJune 4, 2012

Last NPPES UpdateNovember 10, 20202 updates tracked since enumeration

NPPES CertifiedNovember 10, 2020

✔ NPI 1285995589 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080P0203X

License✔ Licensed in MA · 262592

Definition

A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.

55 LAKE AVE N, Worcester, MA 01655

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Other Identifiers 1

Medicaid110099386AMA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Taro Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda C. Johnson M.d. 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.

Medicare Billing Reassignment

Medicare enrollment records show Amanda Johnson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Umass Memorial Medical Group Inc

Same address

Internal Medicine

55 LAKE AVE N
Worcester, MA 01655

Reassigned Medicare billing, Massachusetts enrollment
2,902 clinicians in this Medicare group

NPI 1760445373 (508) 334-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

HILLARY R. IRONS MD

Emergency Medicine

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 421-1400

MS. EILEEN A. DUHAMEL NP

Nurse Practitioner

55 LAKE AVE N, DEPARTMENT OF RADIOLOGY
WORCESTER, MA 01655

Worcester County (508) 334-2710

EWA HRYNISZYN CRNA

Nurse Anesthetist, Certified Registered

55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01655

Worcester County (508) 334-3271

HELEN COPSEY PA-C

Physician Assistant

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 334-8585

DR. ADEPEJU GBADEBO CHAMPION M.D.

Internal Medicine

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 334-2731

SOWMYA KORAPATI

Internal Medicine (Hematology & Oncology)

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 334-3550

LAYLA FAKHRZADEH M.D.

Anesthesiology

55 LAKE AVE N, ANESTHESIOLOGY
WORCESTER, MA 01655

Worcester County (508) 334-3271

YOONYIE CHO M.D.

Anesthesiology

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 334-1000

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 Amanda Johnson's NPI number?

The NPI number for Amanda Johnson is 1285995589. It was assigned to this individual provider in the NPPES registry on June 4, 2012.

Where is Amanda Johnson located?

Amanda Johnson practices at 55 Lake Ave N, Worcester, MA 01655. The listed phone number is (774) 442-2164.

What is Amanda Johnson's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Is Amanda Johnson enrolled in Medicare?

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

Which organization bills Medicare for Amanda Johnson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Amanda Johnson reassigns Medicare benefits to Umass Memorial Medical Group Inc (Worcester, MA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Amanda Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Amanda Johnson accept?

Health plans from Taro Health list Amanda Johnson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Amanda Johnson was last updated on November 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.