JAIME PEDRAZA (NPI# 1790774297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790774297 |
| Entity Type | Individual |
| Full Name | JAIME PEDRAZA |
| Credential | P.A. |
| Practice Address |
30 Medical Center Blvd Bldg 1 Chester PA 19013-3955 |
| Mailing Address |
1 Medical Center Blvd Chester PA 19013-3902 |
| Practice Telephone | 6108746448 |
| Mailing Telephone | 6106197360 |
| Mailing Fax Number | 6106197366 |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2019-01-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA2779 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | PENNSYLVANIA LICENCE | MA-002409-L | 01 |
| FL | MEDICAL LICENSE | PA2779 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 13825 Us Highway 1, Sebastian, FL 329583232 | 7723889998 | 7723889742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033143102 | Jaime Alberto Pedraza | Dentist | Calle1 Hh1 Riverview, Bayamon, PR 00962-6070 | 2006-07-11 |
| 1457585382 | Jaime Pedraza | Family Medicine | 3001 Edwards Mill Rd, # 200, Raleigh, NC 27612-5243 | 2009-05-06 |
| Street Address |
30 MEDICAL CENTER BLVD BLDG 1 |
| City | CHESTER |
| State | PA |
| Zip Code | 19013-3955 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790305043 | Erika Pack | Student in an Organized Health Care Education/Training Program | Crozer-chester Medical Center, 1 Medical Center Blvd., Upland, PA 19013 | 2020-04-16 |
| 1477195287 | Andrew Matthews | Counselor | 301 West 15 Street, Chester, PA 19013 | 2019-10-14 |
| 1780241133 | Raashidah Elizabeth Bowman | Contractor | 1208 Remington Street, Chester, PA 19013 | 2019-05-21 |
| 1134609464 | Shamira Clintonia Johnson | Nurse's Aide | 217 W 5th St, Chester, PA 19013 | 2018-08-16 |
| 1871081299 | Michael Briskey | Student in an Organized Health Care Education/Training Program | 1 Medical Center Blv.d, Chester, PA 19013 | 2018-05-01 |
| 1356845499 | Sonia Gaur | Internal Medicine | 1 Medical Center Blvd Fl 3, Chester, PA 19013 | 2018-03-22 |
| 1548619232 | Beth Barol | Social Worker | 1602 Walnut St, Center for Social Work Education, Chester, PA 19013 | 2016-06-03 |
| 1235594888 | Eryka Jackson | Counselor | 516 West 5th Street, Chester, PA 19013 | 2015-12-28 |
| 1437553146 | Erin Hipple | Counselor | 200 West 9th St, Chester, PA 19013 | 2014-10-09 |
| 1588079867 | Crozer Chester Medical Center | Clinic/Center | 201 Bridgewater Road, Chester Township, PA 19013 | 2014-06-25 |
| Find all providers in zip 19013 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699230219 | Christina Simpson Baumert | Physician Assistant | 30 Medical Center Blvd Ste 202, Chester, PA 19013-3956 | 2019-02-07 |
| 1609497981 | Jessica Hyman | Physician Assistant | 1 Medical Center Blvd, Chester, PA 19013-3995 | 2020-04-28 |
| 1548724107 | Katherine Belliveau | Physician Assistant | 1 Medical Center Blvd, Chester, PA 19013-3902 | 2019-01-29 |
| 1972015154 | Dane Alexander Darnell | Physician Assistant | 1 Medical Center Blvd, Chester, PA 19013-3902 | 2017-10-28 |
| 1558782623 | Shannon Austin Jabs | Physician Assistant | 1716 E Hundred Rd, Suite 102, Chester, VA 23836-3301 | 2013-12-17 |
| 1629330782 | April Chaundra Nellie Foust-ward | Physician Assistant | 1714 E Hundred Rd, Suite 104, Chester, VA 23836-3310 | 2012-06-13 |
| 1013209360 | Jessica Elizabeth Mathieson | Physician Assistant | 30 Medical Center Blvd, Pob #1 - Suite 305, Chester, PA 19013-3955 | 2011-05-04 |
| 1477856979 | Mary Wunderlich | Physician Assistant | 1650 State St, Chester, IL 62233-1001 | 2010-12-06 |
| 1790917888 | Danielle Marie Dinorscia | Physician Assistant | 1 Medical Center Blvd, Chester, PA 19013-3902 | 2009-08-21 |
| 1295907988 | Joan Marie Formiglia | Physician Assistant | 1 E Beacon Light Ln, Chester, PA 19013-4433 | 2008-04-02 |
| Find all providers in CHESTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.