Priscilla Phan Johnson, PA is a medicare enrolled "Physician Assistant" physician in Martinez, Georgia. She graduated from medical school in 2017 and has 7 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Piedmont Professional Services Llc and her current practice location is
1100 W Lake Commons Dr, Martinez, Georgia. You can reach out to her office (for appointments etc.) via phone at
(706) 250-6919.
Priscilla Phan Johnson is licensed to practice in Georgia (license number 11803) 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 1578098695.
Physician's Profile
| Full Name | Priscilla Phan Johnson |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Experience | 7 Years |
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| Location | 1100 W Lake Commons Dr, Martinez, Georgia |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Priscilla Phan Johnson graduated from medical school in 2017
NPI Data:
- NPI Number: 1578098695
- Provider Enumeration Date: 04/26/2017
- Last Update Date: 12/01/2023
Medicare PECOS Information:
- PECOS PAC ID: 2264701614
- Enrollment ID: I20230901002450
Medical Identifiers
Medical identifiers for Priscilla Phan Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1578098695 | NPI | - | NPPES |
| 020947500 | Medicaid | FL | |
| PA9110351 | Other | FL | FLORIDA STATE DOH MEDICAL LICENSURE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 11803 (Georgia) | Secondary |
| 363A00000X | Physician Assistant | PA9110351 (Florida) | Secondary |
| 363AM0700X | Physician Assistant - Medical | PA9110351 (Florida) | Secondary |
| 363A00000X | Physician Assistant | 11803 (Georgia) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Piedmont Professional Services Llc | 8921176231 | 132 |
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. Priscilla Phan 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 |
|---|
Priscilla Phan Johnson, PA
Po Box 11037,
Pensacola, FL 32524-1037
Ph: (850) 444-7000 | Priscilla Phan Johnson, PA
1100 W Lake Commons Dr,
Martinez, GA 30907-7932
Ph: (706) 250-6919 |
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