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

Mr. Dallen M Johnson, CAAMSA

Individual provider Anesthesiologist Assistant · NPI 1629322151

Mr. Dallen M Johnson, CAAMSA is an Anesthesiology Assistant in Rio Rancho, New Mexico. Graduated from Medical College of Wisconsin in 2020, 6 years ago. Practices with Iu Health Medical Group, LLC, a 4,351-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Indiana and New Mexico.

Years since qualifying
6
Trained at
Medical College of Wisconsin
Licensed in
IN, NM
In the registry since
2012
Specialties on file
2

Practice location Address checks out

3001 Broadmoor Blvd NE
Rio Rancho, NM 87144-2100
Phone: (385) 278-9148
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2401 W University Ave, Muncie, IN 47303-3428 — (765) 751-5404

Specialties & licences

Anesthesiologist Assistant (primary) Taxonomy 367H00000X · Licence 75000078A (IN)
Anesthesiologist Assistant Taxonomy 367H00000X · Licence AA2024-0001 (NM)

Record details

NPI number1629322151
Entity typeIndividual (Type 1)
GenderMale
Credentials CAAMSA
Sole proprietorNo
NPI enumeratedNovember 6, 2012
Last updated in NPPESDecember 1, 2025
Certification dateDecember 1, 2025
Mailing address250 N Shadeland Ave, Indianapolis, IN 46219-4959

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY ASSISTANT
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 2020 (6 years in practice)
Group practice Iu Health Medical Group, Llc — 4351 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare