Amanda Nycol Johnson, CPNP is a medicare enrolled "Nurse Practitioner - Pediatrics" in Albertville, Minnesota. Her current practice location is
5703 Lachman Ave Ne, Albertville, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(763) 284-1877.
Amanda Nycol Johnson is licensed to practice in Minnesota (license number 8495) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1851060636.
Provider's Profile
| Full Name | Amanda Nycol Johnson |
|---|
| Gender | Female |
|---|
| Speciality | Nurse Practitioner - Pediatrics |
|---|
| Location | 5703 Lachman Ave Ne, Albertville, Minnesota |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1851060636
- Provider Enumeration Date: 09/07/2021
- Last Update Date: 10/06/2025
Medicare PECOS Information:
- PECOS PAC ID: 9436557204
- Enrollment ID: I20211007003608
Medical Identifiers
Medical identifiers for Amanda Nycol Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1851060636 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LP0200X | Nurse Practitioner - Pediatrics | 8495 (Minnesota) | Primary |
| 363L00000X | Nurse Practitioner | 8495 (Minnesota) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Amanda Nycol Johnson allows following entities to bill medicare on her behalf.
| Entity Name | Lorenz Clinic Llc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1982900510
PECOS PAC ID: 7810282845
Enrollment ID: O20160830000081 |
|---|
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amanda Nycol Johnson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Amanda Nycol Johnson, CPNP
1772 Stieger Lake Ln Ste 220,
Victoria, MN 55386-7720
Ph: (952) 443-4600 | Amanda Nycol Johnson, CPNP
5703 Lachman Ave Ne,
Albertville, MN 55301-3973
Ph: (763) 284-1877 |
Reviews and Comments