Brenda Yvette Collazos Moran

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

033600 Issued in NY

Practice address

7206 Northern Blvd FL 2
Jackson Heights, NY 11372-1049

Phone

(866) 670-6824

NPI assigned

Mar 24, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 3

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

Specialty

Physician Assistant

Education

City University of New York School of Medicine, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New York Queens Medicine and Surgery, P.C.Group PAC ID 4082883673, 401 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: byc7001@direct.nyp.org

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.

• New York Queens Medicine and Surgery, P.C.

  dba Newyork-Presbyterian Medical Group/Queens

  • Pediatrics Physician
  • Fresh Meadows, NY
  • NPI 1003114851
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1144021072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 81ST ST APT 1R",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113725032",
            "telephone_number": "347-813-8037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7206 NORTHERN BLVD FL 2",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113721049",
            "telephone_number": "866-670-6824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLAZOS MORAN",
        "first_name": "BRENDA",
        "middle_name": "YVETTE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-24",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "033600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "6134 188th St Ste 214",
            "city": "Fresh Meadows",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113652726",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "6134 188th St Ste 214",
            "city": "Fresh Meadows",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113652726",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "byc7001@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "6134 188th St Ste 214",
            "city": "Fresh Meadows",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113652726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physician Assistant in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.