Individual provider Active NPI

Ezra Lee

  • Occupational Therapist
  • Newark, DE
National Provider Identifier
1497434187
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
4051 Ogletown Rd Ste 104
Newark, DE 19713-3101
Phone
(302) 894-1600
Fax
(302) 894-1601
NPI assigned
Jul 12, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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 Primary

Addresses

Primary practice location

4051 Ogletown Rd Ste 104
Newark, DE 19713-3101

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

944 Lissicasey Loop
Middletown, DE 19709-9900
Phone (302) 312-0540

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230816002552 DE Practitioner - Occupational Therapist in Private Practice 5395107734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings, LLCGroup PAC ID 9537112719, 440 clinicians

Practice addresses (Care Compare)

4051 Ogletown Rd
104 Ati Physical Therapy
Newark, DE 19713-3101
Phone (302) 894-1600

Merit-based Incentive Payment System (MIPS)

Final score
86.05 of 100Reported as group
Quality
89.12
Improvement activities
40
Cost
73.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Occupational Therapist CurrentSince Jul 28, 2023 Accepting new patients
Ati Holdings, LLC Occupational Therapist CurrentSince Jul 28, 2023 Accepting new patients

Locations

285 Beiser Blvd
Ste 202
Dover, DE 19904
Phone (302) 747-5995

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1497434187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4051 OGLETOWN RD STE 104",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197133101",
            "telephone_number": "302-894-1600",
            "fax_number": "302-894-1601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "944 Lissicasey Loop",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "DE",
            "postal_code": "197099900",
            "country_code": "US",
            "telephone_number": "302-312-0540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "EZRA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-12",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.