Individual provider Active NPI

Nechama Dina Jaffe, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1245719608
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1678 55TH St
Brooklyn, NY 11204-1823
Phone
(172) 005-8909
NPI assigned
Aug 7, 2018
Last updated
Aug 7, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary
Medical Physician Assistant 363AM0700X NU
Surgical Physician Assistant 363AS0400X NU

Addresses

Primary practice location

1678 55TH St
Brooklyn, NY 11204-1823

Mailing address

1678 55TH St
Brooklyn, NY 11204-1823
Phone (917) 200-5890

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
I20181130000344 NY Practitioner - Physician Assistant 8921342031 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

25 Carrier St
Liberty, NY 12754-1903
Phone 84528172004053

2555 Nostrand Ave
Brooklyn, NY 11210-4730
Phone 71895188002102

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ahava Medical and Rehabilitation Center, LLC CurrentSince Jun 1, 2025 Accepting new patients
Jamaica Hospital CurrentSince Jul 15, 2019 Accepting new patients
Parcare Community Health Network Inc CurrentSince May 10, 2020 Accepting new patients
Jamaica Hospital CurrentSince Jul 15, 2019 Accepting new patients
Rockland Medical Group, PLLC PastSince Apr 15, 2017 Accepting new patients
Pharma Holding Inc PastSince Jul 23, 2023 Accepting new patients

Locations

2555 Nostrand Ave
Brooklyn, NY 11210
Phone 7189518800108

445 Park Ave
Brooklyn, NY 11205
Phone (718) 965-1320

6010 Bay Pkwy
Ste 902
Brooklyn, NY 11204
Phone (718) 475-1700

25 Carrier St
Liberty, NY 12754
Phone 84528172004053

80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Networks

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

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1245719608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1678 55TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112041823",
            "telephone_number": "917-200-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1678 55TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112041823",
            "telephone_number": "172-005-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFFE",
        "first_name": "NECHAMA",
        "middle_name": "DINA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.