Kanwal Ejaz, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

295692-1 Issued in NY

Practice address

905 Hanshaw Rd Ste C
Ithaca, NY 14850-1549

Phone

(607) 277-2170

Fax

(607) 277-2329

NPI assigned

May 21, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Internal Medicine

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cayuga Medical Associates PCGroup PAC ID 6709897960, 278 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• VNS Ithaca Tompkins Co Chha Home health agency, Ithaca, NY, CCN 337212
• Cayuga Medical Center at Ithaca Hospital, Ithaca, NY, CCN 330307

Merit-based Incentive Payment System (MIPS)

Final score

94.27 of 100Reported as apm

Quality

82.87

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cayuga Medical Associates, PC

  • Internal Medicine Physician
  • Ithaca, NY
  • NPI 1679525455
  Medicare reassignment Care Compare group NPD
• Boulder Community Health

  dba Community Medical Associates of BCH

  • Medical Specialty Clinic/Center
  • Boulder, CO
  • NPI 1407685498
  NPD (past)
• Boulder Community Health

  dba Community Medical Associates of BCH

  • Multi-Specialty Clinic/Center
  • Boulder, CO
  • NPI 1609822030
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cayuga Medical Center at Ithaca

  • General Acute Care Hospital
  • Ithaca, NY
  • NPI 1962422733
  Care Compare affiliation
• Visiting Nurse Service of Ithaca and Tompkins County Inc

  • Home Health Agency
  • Ithaca, NY
  • NPI 1447257928
  Care Compare affiliation

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1396954178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 HANSHAW RD STE C",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501549",
            "telephone_number": "607-277-2170",
            "fax_number": "607-277-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 HANSHAW RD STE C",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501549",
            "telephone_number": "607-277-2170",
            "fax_number": "607-277-2329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Trumansburg Rd Ste R",
            "address_purpose": "LOCATION",
            "city": "Ithaca",
            "state": "NY",
            "postal_code": "148501397",
            "country_code": "US",
            "telephone_number": "607-277-2170",
            "fax_number": "607-277-2329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EJAZ",
        "first_name": "KANWAL",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0053070",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "208850",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "295692-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05378529",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edward Ambis DDS PC
• Edward G Bryant IV OD PLLC (Clarity Eye Care)
• Sheryl Ann Edwards, SLP
• Allison Egan
• Elizabeth Ann Einstein, LMFT
• Izegbuwa Ashley Ekata
• Celia H Elbrecht, M.D.
• Kathy Eliason, RN
• Ellen C Peterson
• Ellen Maranca LCSW PLLC

• Internal Medicine Physician in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.