Susan Ezzi, ANP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

26NJ00617200 Issued in NJ

Practice address

1086 Dumont Cir
Voorhees, NJ 08043-3500

Phone

(856) 454-9100

NPI assigned

Feb 9, 2016

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Coastal Comprehensive Healthcare, LLC

  • Internal Medicine Physician
  • Wall Township, NJ
  • NPI 1952562936
  Medicare reassignment NPD
• Longevity Clinical LTC Associates of New Jersey

  • Primary Care Nurse Practitioner
  • Lakewood, NJ
  • NPI 1376114322

  Gerontology

  Medicare reassignment NPD

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

{
    "created_epoch": "1454976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1730547480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 MORRISTOWN RD",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079201654",
            "telephone_number": "908-630-9305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1086 DUMONT CIR",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433500",
            "telephone_number": "856-454-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZZI",
        "first_name": "SUSAN",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-09",
        "last_updated": "2023-03-07",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00617200",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00617200",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ BOARD OF NURSING",
            "identifier": "26NO12373900",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ OFFICE OF THE ATTORNEY GENERAL DIVISION OF CONSUMER AFFAIRS CDS",
            "identifier": "P00686400",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ BOARD OF NURSING",
            "identifier": "26NJ00617200",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Kristen Ewashko, DPT
• Executive Center for Psychological Medicine
• Exel-Med Inc
• Eye Physicians PC
• Eye Physicians PC (John D. Dugan Jr.)
• Carolyn Elizabeth Fabian, RN, CRNP
• Katie Facchinei, OT
• Florence Fadare
• Jonathan Val C. Fagel, D.O.
• Alexis Fagotti

• Gerontology Nurse Practitioner in Voorhees, NJ
• Providers in Voorhees, NJ by specialty
• Gerontology Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.