Individual provider Active NPI

Crystal Frazier, PA

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1700080504
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10613 Issued in NY
Practice address
600 E 233Rd St
Bronx, NY 10466-2604
Phone
(718) 920-9256
Fax
(718) 920-6849
NPI assigned
Jun 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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 10613 NY Primary

Addresses

Primary practice location

600 E 233Rd St
Bronx, NY 10466-2604

Mailing address

600 E 233Rd St
Bronx, NY 10466-2604
Phone (718) 920-9135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20230617000337 NJ Practitioner - Physician Assistant 7315962420 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10613NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Past Accepting new patients
Our Lady of Mercy Medical Center Past Accepting new patients

Organizations & group practices 3

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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1700080504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E 233RD ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104662604",
            "telephone_number": "718-920-9135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E 233RD ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104662604",
            "telephone_number": "718-920-9256",
            "fax_number": "718-920-6849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZIER",
        "first_name": "CRYSTAL",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "10613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.