Individual provider Active NPI

Eseroghene Magege, PA

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1790918415
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
..... Issued in NY
Practice address
9807 Foster Ave
Brooklyn, NY 11236-2113
Phone
(347) 435-0203
NPI assigned
Aug 27, 2009
Last updated
Oct 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA64374 CA
Physician Assistant 363A00000X ..... NY Primary

Addresses

Primary practice location

9807 Foster Ave
Brooklyn, NY 11236-2113

Mailing address

31 Doreen Dr
Staten Island, NY 10303-2136
Phone (917) 723-5656

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address emagege103588@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120608000262 NY Practitioner - Physician Assistant 9537323225 Reassigns benefits to 3 organizations
I20250619001800 CA Practitioner - Physician Assistant 9537323225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharwin Tafazoli IncGroup PAC ID 8729416953, 59 clinicians

Practice addresses (Care Compare)

3828 Delmas Ter
Culver City, CA 90232-2713
Phone (310) 836-7000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64374CAMDDentist
PA64374CAMDPhysician Assistant
.....NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Apr 17, 2016 Accepting new patients
New York University CurrentSince Apr 17, 2016 Accepting new patients

Locations

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1790918415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 DOREEN DR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103032136",
            "telephone_number": "917-723-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9807 FOSTER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112362113",
            "telephone_number": "347-435-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGEGE",
        "first_name": "ESEROGHENE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-27",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64374",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": ".....",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emagege103588@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "550 1st Ave",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100166402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.