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Sydney Lee Johnson

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

10 Plum St Fl 5, New Brunswick, NJ 08901-2066

PECOS Enrollment

This provider is enrolled in PECOS as SYDNEY JOHNSON.

Based on the most recent information from CMS, provider Sydney Lee Johnson is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1346729530
Provider Type
Individual
Full Name
Johnson, Sydney Lee
Credential
CRNP

Gender
Female
Sole Proprietor
No
Enumeration Date
8/9/2018
Last Updated
5/8/2023

Contact Information

Practice Location

10 Plum St Fl 5, New Brunswick, NJ 08901-2066

(732) 235-6333

Unlisted Fax

Mailing Location

PO Box 829642, Philadelphia, PA 19182-4735

(866) 470-6626

(413) 599-0470

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 26NJ00938600 New Jersey

Provider Identifiers

ID	Description	Issuer
ID 14357115	Description Other	Issuer CAQH

Sydney Lee Johnson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Drozd, Margaret

Gelinas, Chih-Li

Pechera, Jasper

Aly, Nermin

Vanpelt, Michelle Marie

Cilly, Asha

Salazar, Arcival

Modi, Vrunda

Ku, Anna W

Sanchez, Jessica