Active NPI
Marisol Izurieta
- Physician Assistant
- Jackson Heights, NY
National Provider Identifier
1053280339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 034895
- Practice address
- 9033 Elmhurst Ave
Jackson Heights, NY 11372-7935 - Phone
- (718) 457-7000
- NPI assigned
- Nov 4, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 034895 | NY | Primary |
Addresses
Primary practice location
9033 Elmhurst Ave
Jackson Heights, NY 11372-7935
Mailing address
8642 259TH St
Floral Park, NY 11001-1424
Phone (917) 703-8441
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251119002972 | NY | Order and Referring Only - Internal Medicine | 3971094764 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762214400000",
"number": "1053280339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8642 259TH ST",
"city": "FLORAL PARK",
"state": "NY",
"postal_code": "110011424",
"telephone_number": "917-703-8441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9033 ELMHURST AVE",
"city": "JACKSON HEIGHTS",
"state": "NY",
"postal_code": "113727935",
"telephone_number": "718-457-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IZURIETA",
"first_name": "MARISOL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-11-04",
"last_updated": "2025-11-04",
"certification_date": "2025-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "034895",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson Heights, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.