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

Leah Caroline Johnson

Individual provider Physician Assistant · NPI 1043900244

Leah Caroline Johnson is a Physician Assistant in Burnsville, Minnesota. Qualified in 2025, 1 year ago. Practices with Park Nicollet Clinic, a 1,773-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
1
Licensed in
MN
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

14000 Fairview Dr
Burnsville, MN 55337-5713
Phone: (952) 993-8700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 15566 (MN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1043900244
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 10, 2023
Last updated in NPPESDecember 23, 2025
Certification dateDecember 23, 2025
Mailing address2211 Riverside Ave, Minneapolis, MN 55454-1350

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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