Individual provider Active NPI

Henry Jradeh, PA

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1700681806
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
033237 Issued in NY
Practice address
3319 Kings Hwy Apt 1J
Brooklyn, NY 11234-2622
Phone
(718) 676-4067
NPI assigned
Feb 13, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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 033237 NY Primary

Addresses

Primary practice location

3319 Kings Hwy Apt 1J
Brooklyn, NY 11234-2622

Mailing address

3319 Kings Hwy Apt 1J
Brooklyn, NY 11234-2622
Phone (718) 676-4067

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
I20250918003243 NY Practitioner - Physician Assistant 3173027414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

103 A Stockton St Apt
Suite 3
Brooklyn, NY 11206-5723

1212 Ave V
Brooklyn, NY 11229

1481 McDonald Ave
Brooklyn, NY 11230-4667

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
033237NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Marianna Blokh DPM, P.C. CurrentSince Mar 24, 2025 Accepting new patients
Ilya Blokh MD PC CurrentSince Mar 24, 2025 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": "1739404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1700681806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3319 KINGS HWY APT 1J",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112342622",
            "telephone_number": "718-676-4067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3319 KINGS HWY APT 1J",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112342622",
            "telephone_number": "718-676-4067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JRADEH",
        "first_name": "HENRY",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-13",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "033237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.