Ms Ruby Ezra, A-GNP - Medicare Nurse Practitioner in Port Jefferson Station, NY

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Ms Ruby Ezra, A-GNP is a medicare enrolled "Nurse Practitioner - Adult Health" in Port Jefferson Station, New York. Her current practice location is 163 Stuyvesant Dr, Port Jefferson Station, New York. You can reach out to her office (for appointments etc.) via phone at (631) 342-7514.

Ms Ruby Ezra is licensed to practice in New York (license number F308975-1) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1699088898.

Contact Information

Ms Ruby Ezra, A-GNP
163 Stuyvesant Dr,
Port Jefferson Station, NY 11776-4251
(631) 342-7514
Not Available

Map and Direction




Provider's Profile

Full NameMs Ruby Ezra
GenderFemale
SpecialityNurse Practitioner - Adult Health
Location163 Stuyvesant Dr, Port Jefferson Station, New York
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1699088898
  • Provider Enumeration Date: 07/16/2010
  • Last Update Date: 07/02/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 3173853397
  • Enrollment ID: I20191001000821

Medical Identifiers

Medical identifiers for Ms Ruby Ezra such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1699088898NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163W00000XRegistered Nurse 569398-1 (New York)Secondary
363LA2200XNurse Practitioner - Adult Health F308975-1 (New York)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Ruby Ezra allows following entities to bill medicare on her behalf.
Entity NameDinesh Sethi Physician Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1326392317
PECOS PAC ID: 3678703998
Enrollment ID: O20140307000092
Entity NameEast Coast Gastroenterology And Endoscopy Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1518459569
PECOS PAC ID: 3274889662
Enrollment ID: O20180627000668
Entity NameMy Medical Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1518637891
PECOS PAC ID: 0143610600
Enrollment ID: O20211124001353
Entity NameHeavenly Care Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1164239844
PECOS PAC ID: 3375072549
Enrollment ID: O20250203001058

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Ruby Ezra is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ms Ruby Ezra, A-GNP
163 Stuyvesant Dr,
Port Jefferson Station, NY 11776-4251

Ph: (347) 596-6026		Ms Ruby Ezra, A-GNP
163 Stuyvesant Dr,
Port Jefferson Station, NY 11776-4251

Ph: (631) 342-7514

Reviews and Comments


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Gia Aslanidis,
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Phone: 316-897-8006    Fax: 631-751-0506
Ruth Bochat, FNP-BC
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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.