Individual provider Active NPI

Mariah Dawn Frazier-Espejo, PA-C

  • Medical Physician Assistant
  • New York, NY
National Provider Identifier
1992394209
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
032118 Issued in NY
Practice address
132 Crosby St FL 2
New York, NY 10012-3363
Phone
(212) 280-4740
NPI assigned
Jan 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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 032118 NY Primary

Addresses

Primary practice location

132 Crosby St FL 2
New York, NY 10012-3363

Mailing address

18 Meserole St Apt 3B
Brooklyn, NY 11206-1991
Phone (360) 912-3230

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
I20241016003918 NY Practitioner - Physician Assistant 1355873241 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 2

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": "1610409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1992394209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 MESEROLE ST APT 3B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112061991",
            "telephone_number": "360-912-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 CROSBY ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100123363",
            "telephone_number": "212-280-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZIER-ESPEJO",
        "first_name": "MARIAH",
        "middle_name": "DAWN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-12",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "032118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.