NPIMap

Organization Active NPI

Ezra Medical LLC

  • Internal Medicine Physician
  • Hollywood, FL
National Provider Identifier
1285404962
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
EZRA MEDICAL LLC
Practice address
1780 Polk St FL 11
Suite D
Hollywood, FL 33020-4611
Phone
(917) 509-2538
NPI assigned
Jan 4, 2024
Last updated
Jan 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Authorized official

Name
Isaac Soskin
Title
Member
Phone
(917) 509-2538

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

1780 Polk St FL 11
Suite D
Hollywood, FL 33020-4611

Mailing address

1780 Polk St FL 11
Hollywood, FL 33020-4611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240314003382 FL Part B Supplier - Clinic/Group Practice 1355787110 Receives reassigned benefits from 10 practitioners
Practice locations: Hollywood, FL

National Provider Directory

National Provider Directory

Locations

1780 Polk St
Hollywood, FL 33020

1780 Polk St
Ste D
Hollywood, FL 33020
Phone (917) 509-2538

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704326400000",
    "number": "1285404962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1780 POLK ST FL 11",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330204611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 POLK ST FL 11",
            "address_2": "SUITE D",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330204611",
            "telephone_number": "917-509-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EZRA MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-04",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A",
        "authorized_official_last_name": "SOSKIN",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "917-509-2538"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; 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.