| Jacqueline Johnson, PA-C | |
|
8955 W 400 N, Michigan City, IN 46360-9330 | |
| (219) 861-5800 | |
| (219) 861-5543 |
| Full Name | Jacqueline Johnson |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 20 Years |
| Location | 8955 W 400 N, Michigan City, Indiana |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356617021 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 10005083A (Indiana) | Primary |
| 363A00000X | Physician Assistant | PA22120 (California) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Franciscan Health Michigan City | Michigan city, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| City Of Hope Medical Foundation | 3779751656 | 964 |
| Franciscan Physician Network | 3072790682 | 1152 |
| Entity Name | City of Hope Medical Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871886366 PECOS PAC ID: 3779751656 Enrollment ID: O20110720000244 |
| Mailing Address | Practice Location Address |
|---|---|
| Jacqueline Johnson, PA-C Po Box 781076, Detroit, MI 48278-1008 Ph: (317) 528-4800 | Jacqueline Johnson, PA-C 8955 W 400 N, Michigan City, IN 46360-9330 Ph: (219) 861-5800 |
Victoria Ngozi Anichebe, Physician Assistant Medicare: Medicare Enrolled Practice Location: 1225 E Coolspring Ave Ste 200, Michigan City, IN 46360 Phone: 317-528-4800 Fax: 317-865-1479 |
Ellison Pratley, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3777 N Frontage Rd Ste 900, Michigan City, IN 46360 Phone: 219-921-1444 |
Abigail Gabriela Gemeinhart, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3500 Franciscan Way Ste 300, Michigan City, IN 46360 Phone: 219-877-1101 Fax: 219-877-1187 |
Emily A Damitz, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1225 E Coolspring Ave Ste 300, Michigan City, IN 46360 Phone: 219-878-5032 Fax: 219-878-5052 |
Kevin Smith, P.A. Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1225 E Coolspring Ave, Michigan City, IN 46360 Phone: 219-861-8161 Fax: 219-873-9504 |
Carolyn M Valois, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3500 Franciscan Way Ste 400, Michigan City, IN 46360 Phone: 219-861-8785 Fax: 219-861-8789 |
Kristin Osan, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 8865 W 400 N Ste 120, Michigan City, IN 46360 Phone: 219-878-5031 Fax: 219-879-5498 |