Individual provider Active NPI

Natasha Leeanna Fraser

  • Physician Assistant
  • Elmhurst, NY
National Provider Identifier
1104708239
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
033835-01 Issued in NY
Practice address
79-01 Broadway
Medicine/C6-10
Elmhurst, NY 11373-1329
Phone
(718) 334-4000
NPI assigned
Jul 21, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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 033835-01 NY Primary

Addresses

Primary practice location

79-01 Broadway
Medicine/C6-10
Elmhurst, NY 11373-1329

Mailing address

79-01 Broadway
Medicine/C6-10
Elmhurst, NY 11373-1329
Phone (718) 334-4000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250915003054 NY Practitioner - Physician Assistant 1153824016 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York City Health and Hospitals CorporationGroup PAC ID 4183535305, 543 clinicians

Practice addresses (Care Compare)

7901 Broadway
Elmhurst, NY 11373-1329
Phone (718) 334-4000

8268 164TH St
Jamaica, NY 11432-1121
Phone (718) 883-3000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
033835-01NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation CurrentSince Aug 1, 2025 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Aug 1, 2025 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

7901 Broadway
Flushing, NY 11373
Phone (718) 334-2156

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

50 Water St
Fl 3
New York, NY 10004

Networks

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

Interoperability endpoints

  • Direct secure messaging: nfraser3902217@nychhc.direct-ci.com

Organizations & group practices 5

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": "1753056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1104708239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79-01 BROADWAY",
            "address_2": "MEDICINE/C6-10",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79-01 BROADWAY",
            "address_2": "MEDICINE/C6-10",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRASER",
        "first_name": "NATASHA",
        "middle_name": "LEEANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-21",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "033835-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.