Ezra Gillego, RPA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

011163 Issued in NY

Practice address

1St Ave 16TH Street
New York, NY 10003

Phone

(212) 420-2953

NPI assigned

May 13, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Samaritan Medical Services PCGroup PAC ID 7012016009, 341 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Francis Hospital - the Heart Center Hospital, Roslyn, NY, CCN 330182
• Chsli St Joseph Hospital Hospital, Bethpage, NY, CCN 330332

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

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.

• Samaritan Medical Services, P.C.

  • Internal Medicine Physician
  • West Islip, NY
  • NPI 1124184544
  Medicare reassignment Care Compare group
• Mount Sinai School of Medicine

  • Internal Medicine Physician
  • Oceanside, NY
  • NPI 1508127531
  Medicare reassignment
• St. Francis Hospital

  • General Acute Care Hospital
  • Roslyn, NY
  • NPI 1760704811
  Medicare reassignment
• Mount Sinai School of Medicine

  • Psychiatry Physician
  • Hempstead, NY
  • NPI 1508333956
  NPD
• Mount Sinai School of Medicine

  • Internal Medicine Physician
  • Oceanside, NY
  • NPI 1891262093
  NPD
• St. Francis Hospital

  • Cardiovascular Disease Physician
  • West Islip, NY
  • NPI 1528386810
  NPD

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

• St. Francis Hospital

  • General Acute Care Hospital
  • Roslyn, NY
  • NPI 1043279565
  Care Compare affiliation
• Wsnchs North, Inc.

  • General Acute Care Hospital
  • Bethpage, NY
  • NPI 1013998426
  Care Compare affiliation

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

{
    "created_epoch": "1179014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394496000000",
    "number": "1407061393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 E BEECH ST",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115613604",
            "telephone_number": "516-523-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1ST AVE 16TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "212-420-2953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLEGO",
        "first_name": "EZRA",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-13",
        "last_updated": "2014-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "011163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Gill, L.C.S.W.
• Tanner Gill, MD
• Vimmie Gill
• Sherri L Gillam, CNP
• Patricia Gilleaudeau, FNP
• George Gillen, DDS
• Jeffrey Charles Gillen, PHARMD.
• Jennifer Kathleen Gillen, M.D.
• Rita M. Gillens, CASAC-T
• Bari Nicole Giller, PA

• Surgical Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; 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.