Individual provider Active NPI

Daniel Ezroj, M.D

  • Pediatrics Physician
  • Santa Paula, CA
National Provider Identifier
1225440217
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A144743 Issued in CA
Practice address
258 E Harvard Blvd
Santa Paula, CA 93060-3372
Phone
(805) 525-5518
Fax
(805) 525-9452
NPI assigned
May 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A144743 CA Primary

Addresses

Primary practice location

258 E Harvard Blvd
Santa Paula, CA 93060-3372

Mailing address

5855 Olivas Park Dr
Ventura, CA 93003-7672
Phone (805) 667-2801

Other practice location 1

290 N Wayte Ln
Fresno, CA 93701-2124
Phone (559) 459-5721

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170728001122 CA Practitioner - Pediatric MedicinePractitioner - Family Practice 3577833250 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A144743CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Memorial Health System CurrentSince Jul 1, 2017 Accepting new patients
Community Memorial Health System Current Accepting new patients
Community Memorial Health System CurrentSince Jul 1, 2017 Accepting new patients
Community Memorial Hospital District Past Accepting new patients

Locations

422 Arneill Rd
Ste B
Camarillo, CA 93010
Phone (805) 383-4510

2921 Saviers Rd
Oxnard, CA 93033
Phone (805) 487-5588

2361 E Vineyard Ave
Oxnard, CA 93036
Phone (805) 981-3770

3641 W 5th St
Oxnard, CA 93030
Phone (805) 985-5505

258 E Harvard Blvd
Santa Paula, CA 93060
Phone (805) 525-5518

5855 Olivas Park Dr
Ventura, CA 93003
Phone (805) 652-5469

120 N Ashwood Ave
Ventura, CA 93003
Phone (805) 658-5800

138 W Main St
Ste E
Ventura, CA 93001
Phone (805) 667-2850

147 N Brent St
Ventura, CA 93003
Phone (805) 652-5011

Interoperability endpoints

  • Direct secure messaging: dezroj3509241@oc.providencedirect.org
  • Direct secure messaging: danielezroj@cfh.allscriptsdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1225440217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 OLIVAS PARK DR",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930037672",
            "telephone_number": "805-667-2801",
            "fax_number": "805-667-2865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 E HARVARD BLVD",
            "city": "SANTA PAULA",
            "state": "CA",
            "postal_code": "930603372",
            "telephone_number": "805-525-5518",
            "fax_number": "805-525-9452"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "290 N Wayte Ln",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937012124",
            "country_code": "US",
            "telephone_number": "559-459-5721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EZROJ",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A144743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Paula, CA

Sources for this page

Verify at the official NPI Registry.