Individual provider Active NPI

Brandon Ezzo

  • Occupational Therapist
  • Stow, OH
National Provider Identifier
1336788991
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT010737 Issued in OH
Practice address
3012 Graham Rd
Stow, OH 44224-3622
Phone
(330) 805-4786
NPI assigned
Dec 31, 2019
Last updated
Feb 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT010737 OH Primary

Addresses

Primary practice location

3012 Graham Rd
Stow, OH 44224-3622

Mailing address

3014 Graham Rd
Stow, OH 44224-3622
Phone (330) 805-4786

Other practice location 1

5533 Mahoning Ave Fl 2
Austintown, OH 44515-2366
Phone (330) 799-0094

Other practice location 2

8423 Market St Ste 207
Boardman, OH 44512-6778
Phone (330) 965-5625

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200304000983 OH Practitioner - Occupational Therapist in Private Practice 9234566217 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Purpose Driven Therapy LLCGroup PAC ID 0749515260, 3 clinicians

Practice addresses (Care Compare)

3012 Graham Rd
Stow, OH 44224-3622
Phone (330) 805-4786

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT010737OHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Purpose Driven Therapy LLC Occupational Therapist CurrentSince Feb 3, 2020 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Feb 2, 2026 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Feb 2, 2026 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC Past Accepting new patients

Locations

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

3012 Graham Rd
Stow, OH 44224
Phone (216) 469-5752

3014 Graham Rd
Stow, OH 44224
Phone (330) 805-4786

5533 Mahoning Ave
Fl 2
Youngstown, OH 44515
Phone (330) 480-3533

8423 Market St
Ste 207
Youngstown, OH 44512
Phone (330) 729-7901

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.

NPI Registry JSON

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

{
    "created_epoch": "1577750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1336788991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3014 GRAHAM RD",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442243622",
            "telephone_number": "330-805-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3012 GRAHAM RD",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442243622",
            "telephone_number": "330-805-4786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5533 Mahoning Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Austintown",
            "state": "OH",
            "postal_code": "445152366",
            "country_code": "US",
            "telephone_number": "330-799-0094",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8423 Market St Ste 207",
            "address_purpose": "LOCATION",
            "city": "Boardman",
            "state": "OH",
            "postal_code": "445126778",
            "country_code": "US",
            "telephone_number": "330-965-5625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EZZO",
        "first_name": "BRANDON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-31",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT010737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stow, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.