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

MS. Ivy M. Johnson, PA-C

Individual provider Physician Assistant · NPI 1962553628

MS. Ivy M. Johnson, PA-C is a Physician Assistant in Irvine, California. Graduated from University of Southern California Keck School of Medicine in 2001, 25 years ago. Practices with Align Spine Center, a 7-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
25
Trained at
University of Southern California Keck School of Medicine
Licensed in
CA
In the registry since
2007
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

113 Waterworks Way Ste 240
Irvine, CA 92618-3175
Phone: (949) 340-9622
Fax: (949) 528-3969
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA 15987 (CA)
Physician Assistant Taxonomy 363A00000X · Licence PA15987 (CA)

Record details

NPI number1962553628
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 16, 2007
Last updated in NPPESJune 17, 2026
Certification dateJune 17, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated 2001 (25 years in practice)
Group practice Align Spine Center — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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