Organization Active NPI

Michael D Ezekowitz MD,Inc

  • Cardiovascular Disease Physician
  • Bryn Mawr, PA
National Provider Identifier
1477845246
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD070937L Issued in PA
Legal business name
MICHAEL D EZEKOWITZ MD,INC
Practice address
830 Old Lancaster Rd Ste 301
Bryn Mawr, PA 19010-3118
Phone
(215) 514-5790
Fax
(610) 525-2114
NPI assigned
May 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Authorized official

Name
Michael David Ezekowitz, MD,PHDNPI 1366413296
Title
President/Owner
Phone
(215) 514-5790

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X MD070937L PA Primary

Addresses

Primary practice location

830 Old Lancaster Rd Ste 301
Bryn Mawr, PA 19010-3118

Mailing address

214 N Ithan Ave
Villanova, PA 19085-1936
Phone (215) 514-5790

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111206000165 PA Part B Supplier - Clinic/Group Practice 7416122288 Receives reassigned benefits from 1 practitioner
Practice locations: Bryn Mawr, PA; Wynnewood, PA; Paoli, PA; Media, PA; Broomall, PA

National Provider Directory

National Provider Directory

Locations

1999 Sproul Rd
Ste 26
Broomall, PA 19008
Phone (610) 353-6400

830 Old Lancaster Rd
Ste 301
Bryn Mawr, PA 19010
Phone (215) 514-5790

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778112000000",
    "number": "1477845246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 N ITHAN AVE",
            "city": "VILLANOVA",
            "state": "PA",
            "postal_code": "190851936",
            "telephone_number": "215-514-5790",
            "fax_number": "610-525-2114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 OLD LANCASTER RD STE 301",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103118",
            "telephone_number": "215-514-5790",
            "fax_number": "610-525-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL D EZEKOWITZ MD,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-11",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A",
        "authorized_official_last_name": "EZEKOWITZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "215-514-5790",
        "authorized_official_credential": "MD,PHD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD070937L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2026; 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.