NPIMap

Organization Active NPI

Ezra L. Galler, M.D., LTD.

Doing business as Ezra L. Galler, M.D.

  • Ophthalmology Physician
  • Providence, RI
National Provider Identifier
1184630717
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
9005 Issued in RI
Legal business name
EZRA L. GALLER, M.D., LTD.
Doing business as
Ezra L. Galler, M.D.
Practice address
100 Highland Avenue
Suite 304
Providence, RI 02906
Phone
(401) 728-1400
Fax
(401) 270-9623
NPI assigned
Aug 1, 2006
Last updated
May 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Authorized official

Name
Ezra L Galler, MD
Title
Owner/Provider
Phone
(401) 728-1400

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODTG00496 RI
Optometrist 152W00000X ODTA00502 RI
Ophthalmology Physician 207W00000X 9005 RI Primary

Addresses

Primary practice location

100 Highland Avenue
Suite 304
Providence, RI 02906

Mailing address

100 Highland Avenue
Suite 304
Providence, RI 02865
Phone (401) 728-1400

Other practice location 1

390 Toll Gate Rd Ste 107
Warwick, RI 02886-4326
Phone (401) 732-2662

Other identifiers 1

IdentifierTypeStateIssuer
9025861MedicaidRI

Other names 1

  • Ezra L. Galler, M.D. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041011000005 RI Part B Supplier - Clinic/Group Practice 8921067349 Receives reassigned benefits from 6 practitioners
Practice locations: Warwick, RI; Providence, RI
O20081201000725 MA Part B Supplier - Clinic/Group Practice 8921067349 Receives reassigned benefits from 1 practitioner
Practice locations: Swansea, MA

National Provider Directory

National Provider Directory

Locations

444 Swansea Mall Dr We
Swansea, MA 02777
Phone (508) 324-1171

100 Highland Ave
Ste 304
Providence, RI 02906
Phone (401) 331-2130

390 Toll Gate Rd
Ste 107
Warwick, RI 02886
Phone (401) 732-2662

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778716800000",
    "number": "1184630717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HIGHLAND AVENUE",
            "address_2": "SUITE 304",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02865",
            "telephone_number": "401-728-1400",
            "fax_number": "401-270-9623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGHLAND AVENUE",
            "address_2": "SUITE 304",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02906",
            "telephone_number": "401-728-1400",
            "fax_number": "401-270-9623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "390 Toll Gate Rd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028864326",
            "country_code": "US",
            "telephone_number": "401-732-2662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EZRA L. GALLER, M.D., LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A",
        "authorized_official_last_name": "GALLER",
        "authorized_official_first_name": "EZRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "401-728-1400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "ODTG00496",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "ODTA00502",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "RI",
            "license": "9005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9025861",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ezra L. Galler, M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.