Marie Cameron Pesola, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

005685 Issued in NY

Practice address

575 Grand St Apt E1905
New York, NY 10002-4321

Phone

(212) 982-1708

NPI assigned

Jul 19, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: mpesola680934@nychhc.direct-ci.com

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.

• New York City Health and Hospitals Corporation

  • Clinic/Center
  • New York, NY
  • NPI 1548208127
  Medicare reassignment NPD (past)
• New York City Health and Hospitals Corporation

  • Clinic/Center
  • Bronx, NY
  • NPI 1003824608
  NPD
• New York City Health and Hospitals Corporation

  • Clinic/Center
  • New York, NY
  • NPI 1538943469
  NPD

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1730109406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 GRAND ST APT E1905",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100024321",
            "telephone_number": "212-982-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 GRAND ST APT E1905",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100024321",
            "telephone_number": "212-982-1708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESOLA",
        "first_name": "MARIE",
        "middle_name": "CAMERON",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03751333",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ramon Julian Montilla Pesigan, M.D.
• Patricia Pesiri
• Alexander Peskin, LMFT
• Melissa Peskin
• Mervyn Max Peskin, M.D.
• Maria Fernanda Pessano Fialho
• Madison Anne Pessel, PT, DPT, CSCS
• Julian Pessier, PH.D.
• Hayley Pessin, PH.D.
• Lauren Pesso, LCSW

• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.