Individual provider Active NPI

Ezra Louis L. Galler, M.D.

  • Ophthalmology Physician
  • Providence, RI
National Provider Identifier
1336107382
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
9005 Issued in RI
Practice address
100 Highland Ave
Suite 304
Providence, RI 02906
Phone
(401) 728-1400
Fax
(401) 270-9623
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 9005 RI Primary
Optometrist 152W00000X 00496 RI
Ophthalmology Physician 207W00000X 79430 MA

Addresses

Primary practice location

100 Highland Ave
Suite 304
Providence, RI 02906

Mailing address

100 Highland Ave.
Suite 304
Providence, RI 02906
Phone (401) 728-1400

Other identifiers 1

IdentifierTypeStateIssuer
207MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041027000280 RI Practitioner - Ophthalmology 0941269385 Reassigns benefits to 1 organization
I20050923000086 MA Practitioner - Ophthalmology 0941269385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Boston University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ezra L Galler MD LTDGroup PAC ID 8921067349, 4 clinicians

Practice addresses (Care Compare)

100 Highland Ave
Suite 304
Providence, RI 02906-2753
Phone (401) 728-1400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
22.79 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
75.96

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery109

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00496RIMDOptometrist

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1336107382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HIGHLAND AVE.",
            "address_2": "SUITE 304",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02906",
            "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 AVE",
            "address_2": "SUITE 304",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02906",
            "telephone_number": "401-728-1400",
            "fax_number": "401-270-9623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLER",
        "first_name": "EZRA LOUIS",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "RI",
            "license": "9005",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "00496",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "79430",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.