Individual provider Active NPI

Shahrzad Mojazza, PA

  • Physician Assistant
  • Newburgh, NY
National Provider Identifier
1245449966
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
011692 Issued in NY
Practice address
70 Dubois St
Newburgh, NY 12550-4851
Phone
(845) 561-4400
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 011692 NY Primary

Addresses

Primary practice location

70 Dubois St
Newburgh, NY 12550-4851

Mailing address

1523 Central Park Ave
Apt.11E
Yonkers, NY 10710-6032
Phone (914) 779-4903

Other identifiers 1

IdentifierTypeStateIssuer
011692OtherNYLICENSE

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
I20070815000390 NY Practitioner - Physician Assistant 7012009442 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011692NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jul 23, 2008 Accepting new patients
East Post Road Medical Services PC CurrentSince Jan 27, 2026 Accepting new patients
Montefiore Medical Center CurrentSince Jul 23, 2008 Accepting new patients

Locations

99 Business Park Dr
Armonk, NY 10504
Phone (914) 219-8515

111 E 210th St
Bronx, NY 10467

2532 Grand Concourse
Bronx, NY 10458
Phone (718) 960-1500

19 Laurel Ave
Cornwall, NY 12518
Phone (845) 343-6368

70 Dubois St
Newburgh, NY 12550
Phone (845) 534-4673

300 Community Dr
Plandome, NY 11030

44 S Broadway
White Plains, NY 10601
Phone (914) 390-4300

Networks

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

Interoperability endpoints

  • Direct secure messaging: smojazza@montefioredirect.com

Organizations & group practices 4

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245449966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1523 CENTRAL PARK AVE",
            "address_2": "APT.11E",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107106032",
            "telephone_number": "914-779-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 DUBOIS ST",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125504851",
            "telephone_number": "845-561-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOJAZZA",
        "first_name": "SHAHRZAD",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "011692",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, NY

Sources for this page

Verify at the official NPI Registry.