Ivy M. Johnson, PA-C

NPI 1962553628ActiveIndividual· Physician Assistant, Surgical· Irvine, CA

Physician Assistant, Surgical (PA-C) in Irvine, California, trained at University of Southern California Keck School of Medicine (class of 2001). 95 Medicare patients in 2024, $18,602 paid; nearly all of their 291 Part D prescriptions were generic (97%). Amgen Inc. was the largest of 3 companies reporting payments in 2025, $285.89 in all, mostly food and beverage.

Overview

NPI	1962553628
Status	Active
Entity type	Individual
Credential	PA-C
Sole proprietor	No
NPI issued	Jan 16, 2007
Last updated in NPPES	Jun 17, 2026
Certified by provider	Jun 17, 2026

Specialties and licenses

Taxonomy	Code	License	State
Physician Assistant, Surgical Primary	363AS0400X	PA 15987	CA
Physician Assistant	363A00000X	PA15987	CA

About license numbers in NPPES

Exclusion screening

List	Result	Details
HHS-OIG LEIE · Nov 10, 2026	No match	Checked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026	No match	—
New York OMIG · Nov 11, 2026	No match	—
Ohio Medicaid · Nov 11, 2026	No match	—
Pennsylvania Medicheck · Nov 11, 2026	No match	—
Washington HCA · Nov 11, 2026	No match	—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)	Enrolled Practitioner - Physician Assistant (CA)
Accepts assignment	Yes (participating)

Medicare services in 2024

Medicare patients	95
Services billed	480 across 39 procedure codes
Paid by Medicare	$18,602

Part D prescriptions in 2024

Prescriptions (claims)	291 · 349 30-day fills
Patients	115
Total drug cost	$13,570
Generic share	97% of claims

Medicare sources and data years

Education and affiliations

Medical school	University of Southern California Keck School of Medicine
Graduation year	2001
Medicare specialty	Physician Assistant
Telehealth	Offers telehealth