Mrs Shantae Monae Johnson, AGACNP-BC - Medicare Nurse Practitioner in Detroit, MI

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Mrs Shantae Monae Johnson, AGACNP-BC is a medicare enrolled "Nurse Practitioner - Acute Care" in Detroit, Michigan. She graduated from nursing school in 2016 and has 10 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice City Of Detroit and her current practice location is 100 Mack Ave Fl 1, Detroit, Michigan. You can reach out to her office (for appointments etc.) via phone at (313) 818-8207.

Mrs Shantae Monae Johnson is licensed to practice in Michigan (license number 4704245204) 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 1417406752.

Contact Information

Mrs Shantae Monae Johnson, AGACNP-BC
100 Mack Ave Fl 1,
Detroit, MI 48201-2416
(313) 818-8207
Not Available

Map and Direction




Provider's Profile

Full NameMrs Shantae Monae Johnson
GenderFemale
SpecialityNurse Practitioner
Experience10 Years
Location100 Mack Ave Fl 1, Detroit, Michigan
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:
  • Mrs Shantae Monae Johnson graduated from nursing school in 2016
  NPI Data:
  • NPI Number: 1417406752
  • Provider Enumeration Date: 09/28/2016
  • Last Update Date: 07/29/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 3870878010
  • Enrollment ID: I20170330000760

Medical Identifiers

Medical identifiers for Mrs Shantae Monae Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1417406752NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LA2100XNurse Practitioner - Acute Care 4704245204 (Michigan)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
City Of Detroit14563123882

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. Mrs Shantae Monae Johnson allows following entities to bill medicare on her behalf.
Entity NameVpa PC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1669091864
PECOS PAC ID: 9234041948
Enrollment ID: O20031103000102
Entity NameCity of Detroit
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1033429394
PECOS PAC ID: 1456312388
Enrollment ID: O20041022001114
Entity NamePioneer Medical Group PLLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1801304688
PECOS PAC ID: 5092075598
Enrollment ID: O20180131003349

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. Mrs Shantae Monae 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
Mrs Shantae Monae Johnson, AGACNP-BC
11331 Hazelton,
Redford, MI 48239-1429

Ph: (313) 231-6110		Mrs Shantae Monae Johnson, AGACNP-BC
100 Mack Ave Fl 1,
Detroit, MI 48201-2416

Ph: (313) 818-8207

Reviews and Comments


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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.