NPIMap

Individual provider Active NPI

Garrisson Jean Fabrice Duvivier

  • Physician Assistant
  • New York, NY
National Provider Identifier
1023715638
Registry record updated Mar 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
033035 Issued in NY
Practice address
1275 York Ave
New York, NY 10065-6007
Phone
(347) 798-9213
NPI assigned
Feb 14, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X PA9324 MA
Physician Assistant 363A00000X 033035 NY Primary

Addresses

Primary practice location

1275 York Ave
New York, NY 10065-6007

Mailing address

135 Sumner St W
Brockton, MA 02301-1045

Other practice location 1

75 Francis St
Boston, MA 02115-6106
Phone (617) 732-6248

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230420002698 MA Practitioner - Physician Assistant 2668837923 Reassigns benefits to 3 organizations
I20250416000991 NY Practitioner - Physician Assistant 2668837923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mskcc Radiology GroupGroup PAC ID 3971494683, 192 clinicians

Practice addresses (Care Compare)

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

Hospital & facility affiliations

  • Memorial Hospital for Cancer and Allied Diseases Hospital, New York, NY, CCN 330154

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Medical Associates, Inc. CurrentSince Jun 1, 2023 Accepting new patients
Mass General Brigham Medical Group Suburban Massachusetts Inc Single Specialty CurrentSince Jan 1, 2026 Accepting new patients
Harbor Medical Associates, Inc. Single Specialty CurrentSince Jun 1, 2023 Accepting new patients
Brigham and Womens Physicians Organization Inc Single Specialty Past Accepting new patients

Locations

75 Francis St
Boston, MA 02115

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

541 Main St
Ste 314
Weymouth, MA 02190
Phone (781) 952-1200

541 Main St
Ste 210
Weymouth, MA 02190
Phone (781) 952-1200

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741996800000",
    "number": "1023715638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 SUMNER ST W",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "347-798-9213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Francis St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156106",
            "country_code": "US",
            "telephone_number": "617-732-6248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUVIVIER",
        "first_name": "GARRISSON",
        "middle_name": "JEAN FABRICE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-14",
        "last_updated": "2025-03-15",
        "certification_date": "2025-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA9324",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "033035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.