Kenneth E Ezimoha, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

P135556 Issued in NY

Practice address

15715 19TH Ave
Whitestone, NY 11357-3820

Phone

(718) 746-0408

NPI assigned

Jun 9, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Internal Medicine

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mill Basin Medical Health PCGroup PAC ID 9133566128, 104 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Girling Health Care of New York Home health agency, Brooklyn, NY, CCN 337243

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Mill Basin Medical Health PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1346006202
  Medicare reassignment Care Compare group

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

• HCS Certified Home Care Ny Inc

  dba Girling Health Care of New york, Inc

  • Home Health Agency
  • Brooklyn, NY
  • NPI 1568886653
  Care Compare affiliation

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1760377071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15715 19TH AVE",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113573820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15715 19TH AVE",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113573820",
            "telephone_number": "718-746-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZIMOHA",
        "first_name": "KENNETH",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "P135556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryam Eshaghrashti
• Paola N Espinoza-Narvaez
• Amanda Victoria Esposito
• Julia Everitt
• Excel Together Licensed Behavior Analysis, PLLC
• Curt Faden, LCSW-R ACSW
• Gaelle Anta Fall-Koffi
• Ki Sum Fan
• Fani Dourakis Therapies
• Fanoula LLC

• Internal Medicine Physician in Whitestone, NY
• Providers in Whitestone, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; 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.

Verify at the official NPI Registry.