Mariam Feroza Ejaz, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME134156 Issued in FL

Practice address

1812 Health Care Dr
Trinity, FL 34655-5362

Phone

(813) 731-0944

Fax

(727) 372-3301

NPI assigned

Jul 27, 2006

Last updated

Jun 10, 2021By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Pediatric Health Care Alliance, PA

  • Pediatrics Physician
  • Trinity, FL
  • NPI 1861168643
  NPD
• Pediatric Health Care Alliance

  • Registered Nurse
  • Odessa, FL
  • NPI 1801728738
  NPD (past)
• Pediatric Health Care Alliance, PA

  • Pediatrics Physician
  • Wesley Chapel, FL
  • NPI 1407522352
  NPD (past)
• Pediatric Health Care Alliance, PA

  • Pediatrics Physician
  • Oldsmar, FL
  • NPI 1609965441
  NPD (past)
• Nassau Health Care Corporation

  dba NUMC Department of Family Medicine, FPP

  • General Acute Care Hospital
  • East Meadow, NY
  • NPI 1730530940
  NPD (past)
• Queens Long Island Medical Group, P.C.

  dba AdvantageCare Physicians

  • Internal Medicine Physician
  • New York, NY
  • NPI 1891732038

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1821012121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4033 TAMPA RD",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346773224",
            "telephone_number": "813-854-2003",
            "fax_number": "813-436-5378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 HEALTH CARE DR",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346555362",
            "telephone_number": "813-731-0944",
            "fax_number": "727-372-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EJAZ",
        "first_name": "MARIAM",
        "middle_name": "FEROZA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "240023",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME134156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eastlake Rehab & Care Center LLC (Trinity Regional Rehab Center)
• Ellen Eckelman, MA,PT,DPT
• Graciela F Egli, M.D.
• Richard James Ehrhardt, LMHC
• Thomas F Eiswerth Jr., MD
• Mina Ekladios, MD
• Mohab Eldeeb, MD
• Stephanie Diane Eldridge, M.D.
• Jessica Elmore, ARNP
• Shaymaa Elshaer

• Pediatrics Physician in Trinity, FL
• Providers in Trinity, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.