PEDER JOHNSEN APRN
NPI 1639791577
Nurse Practitioner - Family in Middletown, CT
About Peder Johnsen Aprn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PEDER JOHNSEN APRN (NPI 1639791577) is an individual family provider in Middletown, Connecticut, licensed in Connecticut (8775) and active in the NPI registry since May 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Peder Johnsen Aprn 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.
Medicare Billing Reassignment
Medicare enrollment records show Peder Johnsen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Middletown, CT 06457
- Reassigned Medicare billing, Connecticut enrollment
- Also billed through NPI 1093138935 (Connecticut)
- 147 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.
Areas of Expertise CMS Part B claims 8
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 06457 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
MIDDLETOWN, CT 06457
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 Peder Johnsen's NPI number?
The NPI number for Peder Johnsen is 1639791577. It was assigned to this individual provider in the NPPES registry on May 14, 2020.
Where is Peder Johnsen located?
Peder Johnsen practices at 28 Crescent St, Middletown, CT 06457. The listed phone number is (860) 358-6000.
What is Peder Johnsen's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Peder Johnsen enrolled in Medicare?
Yes. Peder Johnsen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Peder Johnsen's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Peder Johnsen reassigns Medicare benefits to Mhs Primary Care, Inc (Middletown, CT). 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 Peder Johnsen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Peder Johnsen accept?
Health plans from Anthem Blue Cross and Blue Shield list Peder Johnsen 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 Peder Johnsen was last updated on February 24, 2021. 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.
# Peder Johnsen, APRN · NPI 1639791577
Family physician in Middletown, Connecticut. Individual provider, active in the CMS NPPES registry since May 14, 2020.
## Identity
- **NPI:** 1639791577 (Entity type: Individual)
- **Enumerated:** May 14, 2020
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 8775 (Connecticut)
- **Sole proprietor:** No
## Practice location
- **Address:** 28 CRESCENT ST, Middletown, CT 06457-3654
- **Phone:** (860) 358-6000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Mhs Primary Care, Inc (NPI 1336279058, Middletown, CT), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** February 24, 2021
---
Source: [NPI Profile](https://npiprofile.com/npi/1639791577) · Data from the CMS NPPES public registry.