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

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: July 26, 2026.

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

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

Medicare Participation & PECOS CMS

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

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.

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.

When was this NPI record last updated?

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