Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Beau Johnson, PA

Individual provider Physician Assistant · NPI 1699514505

Beau Johnson, PA is a Physician Assistant in Traverse City, Michigan. Qualified in 2024, 2 years ago. Practices with Munson Medical Center, a 377-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
2
Licensed in
MI
In the registry since
2024
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1105 Sixth St
Traverse City, MI 49684-2345
Phone: (231) 935-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1221 Sixth St Ste 300, Traverse City, MI 49684-2360 — (231) 392-0640

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601012454 (MI)

Record details

NPI number1699514505
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 21, 2024
Last updated in NPPESJune 3, 2024
Certification dateJune 3, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Munson Medical Center — 377 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

Other providers in Traverse City