Individual provider Active NPI

Ezra Samuel Lichtman, MD

  • Internal Medicine Physician
  • Chinle, AZ
National Provider Identifier
1720660285
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD2025-0639 Issued in NM
Practice address
US Highway 191
Chinle, AZ 86503
Phone
(928) 674-7001
NPI assigned
Apr 24, 2021
Last updated
Nov 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD2025-0639 NM Primary
Pediatrics Physician 208000000X MD2025-0639 NM

Addresses

Primary practice location

US Highway 191
Chinle, AZ 86503

Mailing address

PO Box PH
Chinle, AZ 86503-8000
Phone (928) 674-7001

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20251218000359 TX Practitioner - Family Practice 7315347085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Yale University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Highway 191 and Hospital Rd
Chinle, AZ 86503-8000
Phone 92867470307030

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD2025-0639NMMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS PHS Naihs Chinle Comprehensive Health Care Facility CurrentSince Nov 3, 2025 Accepting new patients
DHHS PHS Naihs Chinle Comprehensive CurrentSince Nov 3, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: elichtman354963@directhisp.wakemed.org
  • Direct secure messaging: elichtman726209@direct.unc.nchie.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1619222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1720660285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX PH",
            "city": "CHINLE",
            "state": "AZ",
            "postal_code": "865038000",
            "telephone_number": "928-674-7001",
            "fax_number": "928-674-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US HIGHWAY 191",
            "city": "CHINLE",
            "state": "AZ",
            "postal_code": "86503",
            "telephone_number": "928-674-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHTMAN",
        "first_name": "EZRA",
        "middle_name": "SAMUEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-24",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2025-0639",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "MD2025-0639",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chinle, AZ

Sources for this page

Verify at the official NPI Registry.