Ms Nicole A Johnson, PA-C - Medicare Physician Assistant in Carbondale, IL

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Ms Nicole A Johnson, PA-C is a medicare enrolled "Physician Assistant" in Carbondale, Illinois. She went to University Of Nebraska College Of Medicine and graduated in 2011 and has 15 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Deaconess Illinois Specialty Clinic, Inc. and her current practice location is 405 W Jackson St, Carbondale, Illinois. You can reach out to her office (for appointments etc.) via phone at (618) 549-0721.

Ms Nicole A Johnson is licensed to practice in Illinois (license number 085-002903) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1033250576.

Contact Information

Ms Nicole A Johnson, PA-C
405 W Jackson St,
Carbondale, IL 62901-1462
(618) 549-0721
Not Available

Map and Direction




Provider's Profile

Full NameMs Nicole A Johnson
GenderFemale
SpecialityPhysician Assistant
Experience15 Years
Location405 W Jackson St, Carbondale, Illinois
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Ms Nicole A Johnson attended and graduated from University Of Nebraska College Of Medicine in 2011
  NPI Data:
  • NPI Number: 1033250576
  • Provider Enumeration Date: 02/09/2007
  • Last Update Date: 11/09/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 4385714369
  • Enrollment ID: I20080603000148

Medical Identifiers

Medical identifiers for Ms Nicole A Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1033250576NPI-NPPES
085-002903OtherILPA LICENSE NUMBER

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant 085-002903 (Illinois)Primary
363AM0700XPhysician Assistant - Medical 036-087287 (Illinois)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Deaconess Illinois Medical CenterMarion, ILHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Deaconess Illinois Specialty Clinic, Inc.9830562016145

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. Ms Nicole A Johnson allows following entities to bill medicare on her behalf.
Entity NameSouthern Illinois Medical Services Nfp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1770656837
PECOS PAC ID: 3678677390
Enrollment ID: O20070404000595
Entity NameSleep Medicine Associates, LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1861532608
PECOS PAC ID: 2365547817
Enrollment ID: O20070412000201
Entity Name24 on Physicians PC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1346480431
PECOS PAC ID: 5698688141
Enrollment ID: O20090609000389
Entity NameIntegritas Emergency Physician Services LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1790128817
PECOS PAC ID: 7113167446
Enrollment ID: O20130710000760
Entity NameStatera Health Care LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1043874449
PECOS PAC ID: 0244565729
Enrollment ID: O20190708000284
Entity NameDeaconess Illinois Specialty Clinic, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1972210235
PECOS PAC ID: 9830562016
Enrollment ID: O20230321001688

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. Ms Nicole A 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 AddressPractice Location Address
Ms Nicole A Johnson, PA-C
Po Box 3988,
Carbondale, IL 62902-3988

Ph: (618) 457-5200		Ms Nicole A Johnson, PA-C
405 W Jackson St,
Carbondale, IL 62901-1462

Ph: (618) 549-0721

Reviews and Comments


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Mr. Lukas Ward, PA
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Mr. Michael Leroy Matteson, PA C
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John Howard Davidson, PA
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Practice Location: 405 W Jackson St, Carbondale, IL 62901
Phone: 618-549-0721    Fax: 618-457-0469

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.