Individual provider Active NPI

Brocha Fayge Kagan, PA

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1093892267
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
010454 Issued in NY
Practice address
506 6TH St
New York Methodist Hospital
Brooklyn, NY 11215-3609
Phone
(718) 780-3159
Fax
(718) 780-7380
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 010454 NY Primary

Addresses

Primary practice location

506 6TH St
New York Methodist Hospital
Brooklyn, NY 11215-3609

Mailing address

202 Caton Ave
Brooklyn, NY 11218-1617
Phone (718) 215-8650

Other identifiers 1

IdentifierTypeStateIssuer
00246075MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ, MD, MA4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20071105000406 NY Practitioner - Physician Assistant 9537256714 Reassigns benefits to 5 organizations
I20240125002775 NJ Practitioner - Physician Assistant 9537256714 Reassigns benefits to 1 organization
I20240514004068 MD Practitioner - Physician Assistant 9537256714 Reassigns benefits to 1 organization
I20250621000157 MA Practitioner - Physician Assistant 9537256714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Medical PCGroup PAC ID 8325477656, 87 clinicians

Practice addresses (Care Compare)

101 Walnut St
Neptune, NJ 07753-4301
Phone (718) 534-0689

Merit-based Incentive Payment System (MIPS)

Final score
25.46 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
84.86

Merit-based Incentive Payment System (MIPS)

Final score
87.64 of 100Reported as group
Quality
76.13
Improvement activities
40
Cost
69.23

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Parcare Community Health Network Inc CurrentSince Jan 5, 2020 Accepting new patients
Forest Hills Dermatology Group PLLC PastSince Sep 1, 2012 Accepting new patients
Ilyagu Medical PC PastSince Jul 3, 2022 Accepting new patients

Locations

445 Park Ave
Brooklyn, NY 11205
Phone (718) 965-1320

14227 Franklin Ave
Flushing, NY 11355
Phone (516) 205-3663

Networks

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

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1093892267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 CATON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112181617",
            "telephone_number": "718-215-8650",
            "fax_number": "718-780-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 6TH ST",
            "address_2": "NEW YORK METHODIST HOSPITAL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153609",
            "telephone_number": "718-780-3159",
            "fax_number": "718-780-7380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAGAN",
        "first_name": "BROCHA",
        "middle_name": "FAYGE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00246075",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.