Individual provider Active NPI

Maria Quezada, MD

  • Pediatrics Physician
  • Woodhaven, NY
National Provider Identifier
1770799215
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
296263 Issued in NY
Practice address
8714 Jamaica Ave
Woodhaven, NY 11421-2036
Phone
(718) 296-2020
Fax
(718) 296-1781
NPI assigned
May 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 296263 NY Primary

Addresses

Primary practice location

8714 Jamaica Ave
Woodhaven, NY 11421-2036

Mailing address

102 11 Roosevelt Ave.
Corona, NY 11368-2331
Phone (718) 898-5200

Other practice location 1

102 11 Roosevelt Ave.
Corona, NY 11368-2331
Phone (718) 898-5200

Other identifiers 1

IdentifierTypeStateIssuer
01814617MedicaidNY

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
I20160523001069 NY Order and Referring Only - Physician Assistant 6608165139

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
296263NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Center Past Accepting new patients

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FGIGDD/Endpoint/FGIGDD

Organizations & group practices 1

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": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1770799215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 11 ROOSEVELT AVE.",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682331",
            "telephone_number": "718-898-5200",
            "fax_number": "718-898-3673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8714 JAMAICA AVE",
            "city": "WOODHAVEN",
            "state": "NY",
            "postal_code": "114212036",
            "telephone_number": "718-296-2020",
            "fax_number": "718-296-1781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 11 Roosevelt Ave.",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "NY",
            "postal_code": "113682331",
            "country_code": "US",
            "telephone_number": "718-898-5200",
            "fax_number": "718-898-3673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUEZADA",
        "first_name": "MARIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "296263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01814617",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodhaven, NY

Sources for this page

Verify at the official NPI Registry.