Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jedidiah Johnson, PA-C

Individual provider Physician Assistant · NPI 1689155673

Jedidiah Johnson, PA-C is a Physician Assistant in Mesa, Arizona. Qualified in 2018, 8 years ago. Practices with Sonoran Radiology Ltd, a 465-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
8
Licensed in
AZ
In the registry since
2018
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

6424 E Broadway Rd Ste 101
Mesa, AZ 85206-1750
Phone: (480) 456-9000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1201 S Alma School Rd Ste 14000, Mesa, AZ 85210-2096 — (480) 545-9779

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 7194 (AZ)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1689155673
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 27, 2018
Last updated in NPPESJanuary 30, 2019
Mailing address1201 S Alma School Rd Ste 14000, Mesa, AZ 85210-2096

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Sonoran Radiology Ltd — 465 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations9 on file with Medicare

Other providers in Mesa