NPIMap

Individual provider Active NPI

Stephanie Ekizian, M.D.

  • Internal Medicine Physician
  • Elkins Park, PA
National Provider Identifier
1083612659
Registry record updated Apr 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD060966L Issued in PA
Practice address
8302 Old York Rd
Elkins Park, PA 19027-1522
Phone
(215) 885-8550
Fax
(215) 885-8870
NPI assigned
Jul 8, 2005
Last updated
Apr 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD060966L PA Primary

Addresses

Primary practice location

8302 Old York Rd
Elkins Park, PA 19027-1522

Mailing address

8302 Old York Rd
Elkins Park, PA 19027-1522
Phone (215) 885-8550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050429000239 PA Practitioner - Internal Medicine 5890734750 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rutgers New Jersey Medical School, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Abington Memorial HospitalGroup PAC ID 3274437736, 442 clinicians

Practice addresses (Care Compare)

101 E Olney Ave
Philadelphia, PA 19120-2470
Phone (215) 927-1937

8250 Old York Rd
Elkins Park, PA 19027-1514
Phone (215) 885-8550

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD060966LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Abington Memorial Hospital Internal Medicine CurrentSince Jul 1, 2005 Accepting new patients
Einstein Community Health Associates, Inc Internal Medicine CurrentSince Dec 15, 2024 Accepting new patients
Einstein Community Health Associates, Inc CurrentSince Dec 15, 2024 Accepting new patients
Abington Memorial Hospital CurrentSince Jul 1, 2005 Accepting new patients

Locations

1200 York Rd
Abington, PA 19001
Phone (215) 481-2222

8250 Old York Rd
Elkins Park, PA 19027
Phone (215) 884-4729

101 E Olney Ave
Ste C5
Philadelphia, PA 19120
Phone (215) 927-1937

2500 Maryland Rd
Ste 400
Willow Grove, PA 19090
Phone (215) 481-3915

Organizations & group practices 4

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1083612659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8302 OLD YORK RD",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271522",
            "telephone_number": "215-885-8550",
            "fax_number": "215-885-8870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8302 OLD YORK RD",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271522",
            "telephone_number": "215-885-8550",
            "fax_number": "215-885-8870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKIZIAN",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD060966L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkins Park, PA

Sources for this page

Verify at the official NPI Registry.