Active NPI
Schakia Yolanda Eze, D.O.
- Emergency Medicine Physician
- Paterson, NJ
National Provider Identifier
1679702567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 25MB09256900
- Practice address
- 703 Main St
Paterson, NJ 07503-2621 - Phone
- (973) 754-2918
- NPI assigned
- Jul 13, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | 25MB09256900 | NJ | Primary |
Addresses
Primary practice location
703 Main St
Paterson, NJ 07503-2621
Mailing address
575 Easton Ave
Apt 18E
Somerset, NJ 08873-1974
Phone (732) 253-5472
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000000 | Other | NJ | RESIDENCY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- New York College of Osteo Medicine of New York Institute of Technology, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3650 Steve Reynolds Blvd
Duluth, GA 30096-4506
Phone (770) 931-6026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MB09256900 | NJ | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Bortolazzo Group, LLC | Emergency Medicine | Current | Accepting new patients |
| The Southeast Permanente Medical Group | Current | Accepting new patients |
Locations
3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000
3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752
3650 Steve Reynolds Blvd
Duluth, GA 30096
Phone (770) 931-6010
Interoperability endpoints
- https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
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.
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1245266956
-
- Emergency Medicine Physician
- Austell, GA
- NPI 1801965082
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646697600000",
"number": "1679702567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "575 EASTON AVE",
"address_2": "APT 18E",
"city": "SOMERSET",
"state": "NJ",
"postal_code": "088731974",
"telephone_number": "732-253-5472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "703 MAIN ST",
"city": "PATERSON",
"state": "NJ",
"postal_code": "075032621",
"telephone_number": "973-754-2918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EZE",
"first_name": "SCHAKIA",
"middle_name": "YOLANDA",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-13",
"last_updated": "2022-03-08",
"certification_date": "2022-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NJ",
"license": "25MB09256900",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RESIDENCY",
"identifier": "0000000",
"state": "NJ"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "3650 Steve Reynolds Blvd",
"city": "Duluth",
"state": "GA",
"country_code": "US",
"postal_code": "300964506",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Paterson, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.