Jaime Pedraza, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA2779 Issued in FL

Practice address

30 Medical Center Blvd BLDG 1
Chester, PA 19013-3955

Phone

(610) 874-6448

NPI assigned

Oct 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

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

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/0d26bd04-9128-4f58-8e6d-ffda5cd00f89/

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.

• Associates in Anesthesia, Inc.

  • Anesthesiology Physician
  • Chadds Ford, PA
  • NPI 1942281191
  Medicare reassignment
• Associates in Anesthesia

  • Anesthesiology Physician
  • Chadds Ford, PA
  • NPI 1336470467
  NPD (past)
• Brevard Orthopaedic Spine & Pain Clinic Inc

  • Orthopaedic Surgery Physician
  • Melbourne, FL
  • NPI 1548237100
  NPD (past)

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1790774297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190133902",
            "telephone_number": "610-619-7360",
            "fax_number": "610-619-7366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MEDICAL CENTER BLVD BLDG 1",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190133955",
            "telephone_number": "610-874-6448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13825 US Highway 1",
            "address_purpose": "LOCATION",
            "city": "Sebastian",
            "state": "FL",
            "postal_code": "329583232",
            "country_code": "US",
            "telephone_number": "772-388-9998",
            "fax_number": "772-388-9742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEDRAZA",
        "first_name": "JAIME",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA2779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA LICENCE",
            "identifier": "MA-002409-L",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PA2779",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Patton, DMD
• Michele Ann Patton, LPN
• Paul G. Epstein, D.O., P.C.
• Peabody'S in Home Angels LLC
• Peak Performers Home Care Agency
• Marijeta Pekez, M.D.
• Tiara Pendleton
• Penn Home Health Care LLC
• Candace Penny, DNP, CRNA
• Joel R Perloff, MD

• Medical Physician Assistant in Chester, PA
• Providers in Chester, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; 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.