Tiesha D Johnson, PMHNP in Utica, NY - Medicare Nurse Practitioner

Tiesha D Johnson, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Utica, New York. She went to University Of Massachusetts Medical School and graduated in 2008 and has 18 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Pediatric Academic Association, Inc. and her current practice location is 1676 Sunset Ave, Utica, New York. You can reach out to her office (for appointments etc.) via phone at (315) 624-4801.

Tiesha D Johnson is licensed to practice in New York (license number 401131) 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 1104082346.

Contact Information

	Tiesha D Johnson, PMHNP
	1676 Sunset Ave, Utica, NY 13502-5416
	(315) 624-4801
	(315) 624-5401

Map and Direction

Provider's Profile

Full Name	Tiesha D Johnson
Gender	Female
Speciality	Nurse Practitioner
Experience	18 Years
Location	1676 Sunset Ave, Utica, New York
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Tiesha D Johnson attended and graduated from University Of Massachusetts Medical School in 2008

NPI Data:

NPI Number: 1104082346
Provider Enumeration Date: 08/06/2008
Last Update Date: 12/11/2025

Medicare PECOS Information:

PECOS PAC ID: 4385770478
Enrollment ID: I20200519002404

Medical Identifiers

Medical identifiers for Tiesha D Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1104082346	NPI	-	NPPES
0384373	Medicaid	OH

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	401131 (New York)	Primary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	APRN.CNP.024042 (Ohio)	Secondary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Pediatric Academic Association, Inc.	2961306774	188

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. Tiesha D Johnson allows following entities to bill medicare on her behalf.

Entity Name	Pediatric Academic Association, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1063419943 PECOS PAC ID: 2961306774 Enrollment ID: O20031124000198

Entity Name	Marion Area Counseling Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1194051532 PECOS PAC ID: 8729011051 Enrollment ID: O20050915001247

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. Tiesha D 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
Tiesha D Johnson, PMHNP 111 Hospital Dr, Attn: Credentialing Dept, Utica, NY 13502 Ph: (315) 801-8534	Tiesha D Johnson, PMHNP 1676 Sunset Ave, Utica, NY 13502-5416 Ph: (315) 624-4801

Reviews and Comments

Nurse Practitioner Nurses in Utica, NY

Sarah Dunham, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1650 Champlin Ave, Utica, NY 13502 Phone: 315-624-8400
Anida Hodzic, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2206 Pinnacle Dr, Utica, NY 13501 Phone: 315-765-9170
Miss Jenna Yager, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 111 Hospital Dr, Utica, NY 13502 Phone: 315-917-9966
Miss Debra Jane Dermady-ray, RN, ANP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 110 Business Park Dr, Utica, NY 13502 Phone: 315-798-8737
Cynthia A Altieri, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1400 Noyes St, Utica, NY 13502 Phone: 315-797-6800
Thet Thet Mar, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 120 Hobart St, Utica, NY 13501 Phone: 315-798-1149 Fax: 315-734-3565
Barbara Jean Drake, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2211 Genesee St Ste 200, Utica, NY 13501 Phone: 315-733-7598 Fax: 315-733-7694

Tiesha D Johnson, PMHNP - Medicare Nurse Practitioner in Utica, NY