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

Russell Johnson

Individual provider Physician Assistant · NPI 1710345483

Russell Johnson is a Physician Assistant in Milwaukee, Wisconsin. Qualified in 2015, 11 years ago. Practices with Aurora Advanced Healthcare, Inc, a 1,101-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
11
Licensed in
WI
In the registry since
2016
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Practice location Address checks out

2801 W Kinnickinnic River Pkwy Ste 370
Milwaukee, WI 53215-3678
Phone: (414) 649-7900
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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 4642 (WI)

Record details

NPI number1710345483
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 9, 2016
Last updated in NPPESJune 3, 2025
Certification dateJune 3, 2025
Mailing addressPo Box 735044, Chicago, IL 60673-5044

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Aurora Advanced Healthcare, Inc. — 1101 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Milwaukee