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

Mr. Edward Alan Johnson, PAC

Individual provider Family Medicine Physician · NPI 1760595961

Mr. Edward Alan Johnson, PAC is a Physician Assistant in St Augustine, Florida. Qualified in 1997, 29 years ago. Practices with Island Doctors Intrastate LLC, a 76-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
29
Licensed in
FL
In the registry since
2006
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

1099 A1A Beach Blvd
St Augustine, FL 32080
Phone: (904) 471-9104
Fax: (904) 461-3386
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence PA3355 (FL)

Record details

NPI number1760595961
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedAugust 15, 2006
Last updated in NPPESJuly 8, 2007
Mailing address10 13th Street, St Augustine, FL 32080

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Island Doctors Intrastate Llc — 76 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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