Provider Demographics
NPI:1609856723
Name:BRAJER, JASON H (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:H
Last Name:BRAJER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 CORNERSTONE LANE
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-2073
Mailing Address - Country:US
Mailing Address - Phone:610-527-8820
Mailing Address - Fax:610-672-9722
Practice Address - Street 1:601 CORNERSTONE LN
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-2073
Practice Address - Country:US
Practice Address - Phone:610-527-8820
Practice Address - Fax:610-672-9722
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025443E208VP0000X, 208VP0014X, 207LP2900X, 207L00000X
DEC10008831208VP0014X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4516241OtherAETNA PPO
PA0056892000OtherIBC - PC, KHPE
PA143062OtherHIGHMARK BLUE SHIELD
PA1009178OtherKEYSTONE MERCY
DE1609856723Medicaid
PA00104922-0015Medicaid
PA050034053OtherRR MEDICARE
PA2559705OtherAETNA HMO
PAMD025443EOtherHEALTH PARTNERS
PA112418OtherPHCS
PA8068421OtherCIGNA HMO/PPO
PA0056892000OtherAMERIHEALTH/INTERCOUNTY
PA4516241OtherAETNA PPO
PA143062OtherHIGHMARK BLUE SHIELD
PA050034053OtherRR MEDICARE
NYJ400380637Medicare PIN
NYA400170816Medicare PIN
PA0056892000OtherAMERIHEALTH/INTERCOUNTY
PAB39387Medicare UPIN