Individual provider Active NPI

Jessica Mazile, PA

  • Medical Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1184198251
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
3201 Kings Hwy
Brooklyn, NY 11234-2625
Phone
(718) 252-3000
NPI assigned
Jan 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NY Primary

Addresses

Primary practice location

3201 Kings Hwy
Brooklyn, NY 11234-2625

Mailing address

5118 Avenue S
Brooklyn, NY 11234-4625
Phone (347) 355-6189

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
I20251212003446 NY Practitioner - Physician Assistant 0244724573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Modern Physician Services PCGroup PAC ID 6204140544, 55 clinicians

Practice addresses (Care Compare)

1169 Liberty Ave
Brooklyn, NY 11208-3308
Phone (646) 604-8180

6721 Fresh Pond Rd
Ridgewood, NY 11385-4562
Phone (929) 468-9920

68 Graham Ave
Brooklyn, NY 11206-4017
Phone (646) 604-8130

916 Flatbush Ave
Brooklyn, NY 11226-4018
Phone (646) 604-8140

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
023028NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Physician Services PC CurrentSince Sep 11, 2025 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

68 Graham Ave
Brooklyn, NY 11206
Phone (646) 604-8120

85 Broad St
Fl 18
New York, NY 10004
Phone (617) 750-2464

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CHFABD

Organizations & group practices 2

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": "1547164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1184198251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5118 AVENUE S",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112344625",
            "telephone_number": "347-355-6189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112342625",
            "telephone_number": "718-252-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZILE",
        "first_name": "JESSICA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-11",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.