Individual provider Active NPI

Jessica Rae Friedlander, PA

  • Medical Physician Assistant
  • New Bern, NC
National Provider Identifier
1780929737
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-03948 Issued in NC
Practice address
2636 Martin Luther King Jr Blvd
New Bern, NC 28562-4238
Phone
(252) 636-1919
Fax
(252) 636-2656
NPI assigned
Dec 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-03948 NC Primary

Addresses

Primary practice location

2636 Martin Luther King Jr Blvd
New Bern, NC 28562-4238

Mailing address

PO Box 68
Pollocksville, NC 28573-0068
Phone (252) 635-3906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20190201001241 NC Practitioner - Physician Assistant 1557608346 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-03948NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinaeast Physicians CurrentSince Jan 2, 2019 Accepting new patients
Carolinaeast Physicians Past Accepting new patients
Carolinaeast Physicians Past Accepting new patients

Locations

532 Webb Blvd
Havelock, NC 28532
Phone (252) 447-7088

Interoperability endpoints

  • Direct secure messaging: jfriedlander19403@carolinaeastmc.direct-ci.com

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": "1354492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1780929737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68",
            "city": "POLLOCKSVILLE",
            "state": "NC",
            "postal_code": "285730068",
            "telephone_number": "252-635-3906",
            "fax_number": "252-224-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2636 MARTIN LUTHER KING JR BLVD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285624238",
            "telephone_number": "252-636-1919",
            "fax_number": "252-636-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDLANDER",
        "first_name": "JESSICA",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-03",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-03948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

Verify at the official NPI Registry.