MR. TREVOR R JOHNSON
NPI 1669347951
Nurse Practitioner - Primary Care in Waterloo, NY
About Mr. Trevor R Johnson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. TREVOR R JOHNSON (NPI 1669347951) is an individual primary care provider in Waterloo, New York, licensed in New York (F357797-01) and active in the NPI registry since October 2025. He is enrolled in Medicare PECOS, is affiliated with Geneva General Hospital, and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mr. Trevor R Johnson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Geneva General Hospital
Acute Care Hospitals · Geneva, NYSoldiers And Sailors Memorial Hospital Of Yates
Critical Access Hospitals · Penn Yan, NYPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 13165 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Trevor Johnson's NPI number?
The NPI number for Trevor Johnson is 1669347951. It was assigned to this individual provider in the NPPES registry on October 7, 2025.
Where is Trevor Johnson located?
Trevor Johnson practices at 367 E Main St Ste A, Waterloo, NY 13165. The listed phone number is (315) 787-4977.
What is Trevor Johnson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Is Trevor Johnson enrolled in Medicare?
Yes. Trevor Johnson is registered in the Medicare PECOS enrollment system.
Is Trevor Johnson affiliated with any hospitals?
According to CMS data, Trevor Johnson is affiliated with Geneva General Hospital and Soldiers And Sailors Memorial Hospital Of Yates.
When was this NPI record last updated?
The NPPES record for Trevor Johnson was last updated on October 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Mr. Trevor R Johnson · NPI 1669347951
Primary Care physician in Waterloo, New York. Individual provider, active in the CMS NPPES registry since October 7, 2025.
## Identity
- **NPI:** 1669347951 (Entity type: Individual)
- **Enumerated:** October 7, 2025
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **State license:** F357797-01 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 367 E MAIN ST STE A, Waterloo, NY 13165-1643
- **Phone:** (315) 787-4977
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** October 7, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1669347951) · Data from the CMS NPPES public registry.