1. Home
  2. Directory
  3. Tennessee
  4. Johnson City
  5. Physician Assistant
  6. NPI Profile

BENJAMIN HAYES EZELL PA
NPI 1174343073
Physician Assistant - Medical in Johnson City, TN

Active since October 15, 2024Opted out of Medicare · through Feb 10, 2027
2244 BOONES CREEK RD, JOHNSON CITY, TN 37615(423) 753-4000 Get Directions Write a Review

NPPES record last updated: October 15, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Benjamin Hayes Ezell Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BENJAMIN HAYES EZELL PA (NPI 1174343073) is an individual medical provider in Johnson City, Tennessee, licensed in Tennessee (6207) and active in the NPI registry since October 2024. He has opted out of Medicare through February 10, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1174343073
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameBENJAMIN HAYES EZELLCredential: PA
Location Address2244 BOONES CREEK RDJohnson City, TN 37615-4432
Mailing Address2244 Boones Creek RdJohnson City, TN 37615-4432
Phone(423) 753-4000
Sole ProprietorNo
Enumeration DateOctober 15, 2024
NPPES CertifiedSeptember 16, 2024
✔ NPI 1174343073 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in TN · 6207
2244 BOONES CREEK RD, Johnson City, TN 37615
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Benjamin Hayes Ezell Pa has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 10, 2025 through February 10, 2027.

Opt-Out Effective DateFebruary 10, 2025
Opt-Out In Effect ThroughFebruary 10, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. MEG WILLIAMS ELLIS PA-C
Physician Assistant (Medical)
2244 BOONES CREEK RD
JOHNSON CITY, TN 37615
Washington County (423) 753-4000
HEATHER BISHOP PA-C
Physician Assistant
2244 BOONES CREEK RD
JOHNSON CITY, TN 37615
Washington County (423) 753-4000
GENESIS FAMILY HEALTHCARE PLLC
Family Medicine
2244 BOONES CREEK RD
GRAY, TN 37615
Washington County (423) 753-4000
GENESIS CENTER FOR WELLNESS
Family Medicine
2244 BOONES CREEK RD
JOHNSON CITY, TN 37615
Washington County (423) 788-3294
MR. JACK CLAUDIOUS JUSTICE III PA-C
Physician Assistant
2244 BOONES CREEK RD
JOHNSON CITY, TN 37615
Washington County (423) 782-0243

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Benjamin Ezell's NPI number?

The NPI number for Benjamin Ezell is 1174343073. It was assigned to this individual provider in the NPPES registry on October 15, 2024.

Where is Benjamin Ezell located?

Benjamin Ezell practices at 2244 Boones Creek Rd, Johnson City, TN 37615. The listed phone number is (423) 753-4000.

What is Benjamin Ezell's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Benjamin Ezell enrolled in Medicare?

No. Benjamin Ezell has opted out of Medicare through February 10, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Benjamin Ezell was last updated on October 15, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.