BLAKE JOHNSON MPAS, PA-C
NPI 1851036214
Physician Assistant - Surgical in Denver, CO

Q: What is Blake Johnson's NPI number?

The NPI number for Blake Johnson is 1851036214. It was assigned to this individual provider in the NPPES registry on April 30, 2022.

Q: What is Blake Johnson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Blake Johnson was last updated on September 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.

Active since April 30, 2022PECOS EnrolledAccepts Medicare Assignment

777 BANNOCK ST, DENVER, CO 80204(303) 436-6000 Get Directions Write a Review

NPPES record last updated: September 11, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 11, 2024, Jul 30, 2024, Apr 30, 2022 (3 updates tracked since 2022).

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About Blake Johnson Mpas, Pa-c NPPES

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

BLAKE JOHNSON MPAS, PA-C (NPI 1851036214) is an individual surgical provider in Denver, Colorado and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS, maintains a secondary practice location in Salt Lake City, and is a graduate of University Of Utah School Of Medicine (2024).

NPPES Registry Identity

NPI1851036214

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameBLAKE JOHNSONCredential: MPAS, PA-C

Location Address777 BANNOCK STDenver, CO 80204-4507

Mailing Address475 N Redwood Rd Unit 16Salt Lake City, UT 84116-3565 · (801) 584-9449

Phone(303) 436-6000

Sole ProprietorYes

Medical School CMSUniversity Of Utah School Of MedicineGraduated 2024

Enumeration DateApril 30, 2022

Last NPPES UpdateSeptember 11, 20243 updates tracked since enumeration

NPPES CertifiedSeptember 11, 2024

✔ NPI 1851036214 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

777 BANNOCK ST, Denver, CO 80204

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Secondary Practice Location 1

Location 1475 N Redwood Rd Unit 16Salt Lake City, UT 84116-3565 · Phone (801) 584-9449

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Blake Johnson Mpas, Pa-c 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.

PECOS PAC ID2163942525

PECOS Enrollment IDI20250228001154

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.

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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.

MS. KATHERINE JEANNE CARLEY RN, MSN, CS

Clinical Nurse Specialist (Psychiatric/Mental Health)