AMANDA GRACE JOHNSON
NPI 1376289793
Student in an Organized Health Care Education/Training Program in Quincy, MA

Active since May 09, 2022PECOS Enrolled
460 QUINCY AVE, QUINCY, MA 02169(800) 528-4890 Get Directions Write a Review

NPPES record last updated: May 9, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Amanda Grace Johnson NPPES

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

AMANDA GRACE JOHNSON (NPI 1376289793) is an individual student in an organized health care education/training program in Quincy, Massachusetts and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1376289793
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameAMANDA GRACE JOHNSON
Location Address460 QUINCY AVEQuincy, MA 02169-8130
Mailing Address500 Victory RdQuincy, MA 02171-3139
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateMay 9, 2022
NPPES CertifiedMay 9, 2022
✔ NPI 1376289793 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
460 QUINCY AVE, Quincy, MA 02169

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda Grace Johnson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3375012438
PECOS Enrollment IDI20260518003369
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.

Mental Health (Including Community Mental Health Center)
54 MILLER ST
Quincy, MA 02169
  • Reassigned Medicare billing, Massachusetts enrollment
  • 101 clinicians in this Medicare group

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.

Counselor (Mental Health)
460 QUINCY AVE
QUINCY, MA 02169
Counselor (Mental Health)
460 QUINCY AVE
QUINCY, MA 02169
Clinical Nurse Specialist (Psychiatric/Mental Health, Adult)
460 QUINCY AVE
QUINCY, MA 02169
Counselor (Mental Health)
460 QUINCY AVE
QUINCY, MA 02169
Case Manager/Care Coordinator
460 QUINCY AVE
QUINCY, MA 02169
Health Educator
460 QUINCY AVE
QUINCY, MA 02169
Social Worker (Clinical)
460 QUINCY AVE, SOUTH SHORE MENTAL HEALTH
QUINCY, MA 02169
Registered Nurse
460 QUINCY AVE
QUINCY, MA 02169

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 1376289793. It was assigned to this individual provider in the NPPES registry on May 9, 2022.

Where is Amanda Johnson located?

Amanda Johnson practices at 460 Quincy Ave, Quincy, MA 02169. The listed phone number is (800) 528-4890.

What is Amanda Johnson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

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 South Shore Mental Health Center, Inc. (Quincy, 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.

When was this NPI record last updated?

The NPPES record for Amanda Johnson was last updated on May 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.