Active NPI
Ebenezer Zentah Fozao, MD, DO.
- Emergency Medicine Physician
- Tyler, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- T6568
- Practice address
- 800 E Dawson St
Tyler, TX 75701-2036 - Phone
- (903) 606-4262
- NPI assigned
- Apr 12, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | T6568 | TX | Primary |
Addresses
Primary practice location
800 E Dawson St
Tyler, TX 75701-2036
Mailing address
PO Box 841656
Dallas, TX 75284-1656
Phone (903) 531-5000
Other practice location 1
2201 Hempstead Tpke
East Meadow, NY 11554-1859
Phone (516) 296-2899
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
719 W Coke Rd
Winnsboro, TX 75494-3011
Phone (903) 342-5227
Hospital & facility affiliations
- Christus Mother Frances Hospital Sulphur Springs
- Christus Mother Frances Hospital
- Christus Mother Frances Hospital- Winnsboro
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mother Frances Hospital Jacksonville | Current | Accepting new patients | |
| Mother Frances Hospital Regional Health Care Center | Current | Accepting new patients | |
| Christus Trinity Clinic Texas | Current | Accepting new patients | |
| Northeast Texas Emergency Physicians, PLLC | Emergency Medicine | Current | Accepting new patients |
| Christus Trinity Clinic Texas | Current | Accepting new patients |
Locations
1007 S William St
Atlanta, TX 75551
Phone (903) 614-2000
2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500
630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888
800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018
719 W Coke Rd
Winnsboro, TX 75494
Phone (903) 342-3961
Organizations & group practices 5
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.
-
- Emergency Medicine Physician
- Longview, TX
- NPI 1114607611
-
- Family Medicine Physician
- Tyler, TX
- NPI 1285684225
-
- Critical Access Hospital
- Jacksonville, TX
- NPI 1952306672
-
- General Acute Care Hospital
- Tyler, TX
- NPI 1679578439
-
- Rural Health Clinic/Center
- Winnsboro, TX
- NPI 1801673165
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Sulphur Springs, TX
- NPI 1033568621
-
- General Acute Care Hospital
- Tyler, TX
- NPI 1679578439
-
- Critical Access Hospital
- Winnsboro, TX
- NPI 1659308948
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661385600000",
"number": "1861999021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 841656",
"city": "DALLAS",
"state": "TX",
"postal_code": "752841656",
"telephone_number": "903-531-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E DAWSON ST",
"city": "TYLER",
"state": "TX",
"postal_code": "757012036",
"telephone_number": "903-606-4262"
}
],
"practiceLocations": [
{
"address_1": "2201 Hempstead Tpke",
"address_purpose": "LOCATION",
"city": "East Meadow",
"state": "NY",
"postal_code": "115541859",
"country_code": "US",
"telephone_number": "516-296-2899",
"fax_number": "516-572-5465",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FOZAO",
"first_name": "EBENEZER",
"middle_name": "ZENTAH",
"name_prefix": "Dr.",
"credential": "MD, DO.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-12",
"last_updated": "2022-08-25",
"certification_date": "2022-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "TX",
"license": "T6568",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.