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

Justin Michael Johnson, PA-C

Individual provider Physician Assistant · NPI 1619362480

Justin Michael Johnson, PA-C is a Physician Assistant in Boise, Idaho. Qualified in 2014, 12 years ago. Practices with Saint Alphonsus Regional Medical Center Inc, a 673-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho and Utah.

Years since qualifying
12
Licensed in
ID, UT
In the registry since
2015
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

1075 N Curtis Rd Ste 300
Boise, ID 83706-1348
Phone: (208) 302-3100
Fax: (208) 302-3155
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3895 Harrison Blvd, Ogden, UT 84403-2312 — (801) 387-7678

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-2296 (ID)
Physician Assistant Taxonomy 363A00000X · Licence 10816599-1206 (UT)

Record details

NPI number1619362480
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedMarch 30, 2015
Last updated in NPPESAugust 26, 2022
Certification dateAugust 26, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Saint Alphonsus Regional Medical Center Inc — 673 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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