Individual provider Active NPI

Shoshana Brawer, PA-C

  • Physician Assistant
  • Jamaica, NY
National Provider Identifier
1760067979
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
9420 Guy R Brewer Blvd
Jamaica, NY 11451-0001
Phone
(718) 262-2000
NPI assigned
Mar 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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 Primary

Addresses

Primary practice location

9420 Guy R Brewer Blvd
Jamaica, NY 11451-0001

Mailing address

679 Montgomery St Apt 4B
Brooklyn, NY 11213-5115
Phone (347) 362-7564

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
I20260428000463 NY Practitioner - Physician Assistant 5597136416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

679 Montgomery St Apt
4B
Brooklyn, NY 11213-5115

74 Wallabout St
Brooklyn, NY 11249-7830

9 Meron Dr
Monroe, NY 10950-8436

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
026982NYMDOccupational Therapist

Practice roles (3 of 6)

OrganizationSpecialtyStatusNew patients
Oda Primary Health Care Network, Inc. Past Accepting new patients
Oda Primary Health Care Network, Inc. Past Accepting new patients
Oda Primary Health Care Network, Inc. Past Accepting new patients

Networks

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

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": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1760067979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "679 MONTGOMERY ST APT 4B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112135115",
            "telephone_number": "347-362-7564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9420 GUY R BREWER BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114510001",
            "telephone_number": "718-262-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAWER",
        "first_name": "SHOSHANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-10",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.