Individual provider Active NPI

Pamela Frayna Baga

  • Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1194240507
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
308356 Issued in NY
Practice address
1645 E 19TH St
Brooklyn, NY 11229-1311
Phone
(718) 265-5858
NPI assigned
Aug 7, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 308356 NY Primary

Addresses

Primary practice location

1645 E 19TH St
Brooklyn, NY 11229-1311

Mailing address

1645 E 19TH St
Brooklyn, NY 11229-1311

Other practice location 1

951 Brook Ave Ste 202
Bronx, NY 10451-4209
Phone (718) 993-9700

Other identifiers 1

IdentifierTypeStateIssuer
308356OtherNYNEW YORK STATE REGISTERED NURSE PRACTITIONER LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

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": "1502064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1194240507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 E 19TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 E 19TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291311",
            "telephone_number": "718-265-5858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "951 Brook Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104514209",
            "country_code": "US",
            "telephone_number": "718-993-9700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAGA",
        "first_name": "PAMELA",
        "middle_name": "FRAYNA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "308356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE REGISTERED NURSE PRACTITIONER LICENSE",
            "identifier": "308356",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.