Active NPI 1295877785 Individual Practitioner Female Practitioner

Lisa Marie Johnson , PA

Physician Assistant - Medical • Indialantic, FL

Professional Overview & Biography Verified Profile Summary

Lisa Johnson, PA is a registered healthcare professional specializing in Physician Assistant - Medical in Indialantic, FL. Practice services are available at 150 5TH AVE STE A under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

150 5th Ave Ste A

Indialantic, FL 329033154

Telephone 3212546803

Fax 3212546819

Associated Practice Facility / Clinic

🏢 Baytree Medical Group Llc Facility NPI 1780874628

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant - Medical in Indialantic, FL

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 15.5 Yrs

Regional Practice Density

1 Specialists

Practicing in Indialantic, FL (2836 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-03-28

Physician Assistant - Medical Primary Specialty

NUCC Taxonomy Code: 363AM0700X

State License FL PA9108416

Definition to come...

Physician Assistant - Medical

NUCC Taxonomy Code: 363AM0700X

State License OK 1338

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

200028010A (OK)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners

Dr. Rebecca Hunton , MD

Family Medicine - Adult Medicine

NPI 1295776516

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events

📍

Updated Practice Location March 28, 2022

Registered at 150 5TH AVE STE A, INDIALANTIC, FL 329033154 (Tel: 3212546803)

📍

Updated Business Mailing Address March 28, 2022

Registered at 150 5TH AVE STE A, INDIALANTIC, FL 329033154 (Tel: 3212546803)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 28, 2022

Physician Assistant (License #1338 in OK)

✅

NPI Profile Active May 14, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location May 14, 2016

Registered at 150 5TH AVE, SUITE C, INDIALANTIC, FL 329033154 (Tel: 3212546803)

📍

Updated Business Mailing Address May 14, 2016

Registered at 150 5TH AVE, SUITE C, INDIALANTIC, FL 329033154 (Tel: 3212546803)

👤

Provider Name / Credentials Updated May 14, 2016

Recorded as LISA JOHNSON, P.A.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 14, 2016

Physician Assistant (License #PA9108416 in FL)

🟢

Initial NPI Registration & Enumeration February 13, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews

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NPI Administrative Meta

NPI Number: 1295877785

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: February 13, 2007

Last Update: March 28, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

150 5th Ave Ste A

Indialantic, FL 329033154

Phone: 3212546803

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.