Omar Ezziddin, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

036131711 Issued in IL

Practice address

908 Allen St
Springfield, MA 01118-2533

Phone

(413) 796-7494

NPI assigned

Apr 21, 2009

Sex

Male

Sole proprietor

Yes

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

Enrolled in MA, CT2 enrollments

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 2

Specialty

Anesthesiology

Education

Ohio State University College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mass General Brigham Medical Group Western Massachusetts IncGroup PAC ID 2567359839, 291 clinicians

Pulse Anesthesia Consultants PCGroup PAC ID 8921479809, 16 clinicians

Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cooley Dickinson Hospital Inc,the Hospital, Northampton, MA, CCN 220015
• Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163

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.

• Mass General Brigham Medical Group Western Massachusetts Inc

  • Family Medicine Physician
  • Northampton, MA
  • NPI 1295787919
  Medicare reassignment Care Compare group NPD
• Pulse Anesthesia Consultants PC

  • Anesthesiology Physician
  • Springfield, MA
  • NPI 1407560618
  Medicare reassignment Care Compare group NPD
• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373

  Anesthesiology

  Medicare reassignment Care Compare group NPD
• Pioneer Sedation PLLC

  • Certified Registered Nurse Anesthetist
  • Springfield, MA
  • NPI 1154886810
  Medicare reassignment NPD
• Springfield Anesthesia Service, Inc.

  • Anesthesiology Physician
  • Springfield, MA
  • NPI 1093768830
  Medicare reassignment NPD
• Connecticut Gi PLLC

  • Gastroenterology Physician
  • Hartford, CT
  • NPI 1023124625
  Medicare reassignment NPD
• Amsurg Mdsine Anesthesia LLC

  • Anesthesiology Physician
  • Springfield, MA
  • NPI 1932521366
  Medicare reassignment
• Woodland Anesthesia Associates PC

  • Anesthesiology Physician
  • Hartford, CT
  • NPI 1437109824

  MA

  Medicare reassignment
• Umass Memorial Medical Group, Inc.

  dba Urgent Care Express at Harrington

  • Urgent Care Clinic/Center
  • Oxford, MA
  • NPI 1982381018
  NPD

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

• Cooley Dickinson Hospital Inc

  • General Acute Care Hospital
  • Northampton, MA
  • NPI 1477596310
  Care Compare affiliation
• Cooley Dickinson Hospital Inc

  • Psychiatric Hospital Unit
  • Northampton, MA
  • NPI 1871512814
  Care Compare affiliation
• Umass Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Worcester, MA
  • NPI 1831151455
  Care Compare affiliation

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1821232901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 ALLEN ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011182533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 ALLEN ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011182533",
            "telephone_number": "413-796-7494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-334-3271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EZZIDDIN",
        "first_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-21",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036131711",
            "primary": true
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "IL",
            "license": "036131711",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Excelsure Homes Health Care Solutions LLC
• Eye Sight & Surgery Assoc PC
• Bernice A Ezell, NP
• Tunisia V. Ezell, MSW
• Bryan Ezema, MD
• Daniel Fabian, M.ED.
• Jacqueline M Fable, M.D.
• Joseph Fabozzi, DO
• Michael S. Fabrizi, PH.D
• Danielle Marie Fafard

• Anesthesiology Physician in Springfield, MA
• Providers in Springfield, MA by specialty
• Anesthesiology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.
• 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.