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EZRA MARGONO MD
NPI 1720647829
Radiology - Diagnostic Radiology in Boston, MA

Active since June 12, 2019PECOS EnrolledAccepts Medicare Assignment

NPPES record last updated: April 29, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 29, 2024, Jul 7, 2020, Jun 12, 2019 (3 updates tracked since 2019).

About Ezra Margono Md NPPES

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

EZRA MARGONO MD (NPI 1720647829) is an individual diagnostic radiology provider in Boston, Massachusetts, licensed in Massachusetts (1018248) and active in the NPI registry since June 2019. He is enrolled in Medicare PECOS, is affiliated with Cambridge Health Alliance, and maintains a secondary practice location in Boston.

NPPES Registry Identity

NPI1720647829
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameEZRA MARGONOCredential: MD
Location Address55 FRUIT STBoston, MA 02114-2621
Mailing Address820 Harrison Ave Bldg 4thBoston, MA 02118-2905
Phone(617) 643-7860
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateJune 12, 2019
Last NPPES UpdateApril 29, 20243 updates tracked since enumeration
NPPES CertifiedApril 29, 2024
✔ NPI 1720647829 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License✔ Licensed in MA · 1018248
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
55 FRUIT ST, Boston, MA 02114
Open in Google Maps ↗

Secondary Practice Location 1

Location 1820 Harrison Ave Bldg 4thBoston, MA 02118-2905 · Phone (516) 663-2051

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ezra Margono Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2769800028
PECOS Enrollment IDI20240626000372
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Cambridge Health Alliance

Acute Care Hospitals · Cambridge, MA
3/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number220011
Location1493 Cambridge StreetCambridge, MA 02138 · Middlesex County
Emergency services Birthing friendly

Beth Israel Deaconess Medical Center

Acute Care Hospitals · Boston, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220086
Location330 Brookline AvenueBoston, MA 02215 · Suffolk County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02114 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$97.64 typical visit price
range $63.72 – $189.86
Typical copayment $24.41 (range $15.93 – $47.46)
Most-billed visit code 99203
Established Patient
$78.84 typical visit price
range $21.07 – $155.29
Typical copayment $19.71 (range $5.26 – $38.82)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

STUTI GIRISH SHROFF MD, MBBS
Pathology (Anatomic Pathology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2971
NANCY WANG M.D.
Internal Medicine (Hematology & Oncology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (017) 724-4000
DR. DUSAN HANIDZIAR M.D., PH.D.
Anesthesiology
55 FRUIT ST, GRAY-BIGELOW 444
BOSTON, MA 02114
Suffolk County (617) 726-3030
JOHN JOSEPH DANKO DO
Physical Medicine & Rehabilitation
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2000
DR. MICHAEL ANDREW LOBRITZ M.D, PH.D.
Internal Medicine (Infectious Disease)
55 FRUIT ST, DIVISION OF INFECTIOUS DISEASE, GRJ-504
BOSTON, MA 02114
Suffolk County (617) 724-9248
MS. KELLY ELISHA TRECARTIN NP
Nurse Practitioner (Acute Care)
55 FRUIT ST, BIGALOW 852 F
BOSTON, MA 02114
Suffolk County (617) 726-7400
JAMIE MARIE ALLEN NP
Nurse Practitioner
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 724-4410
DR. DHAVAL SANJEEV KOLTE M.B.B.S., PH.D.
Internal Medicine (Cardiovascular Disease)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 643-3238

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 Ezra Margono's NPI number?

The NPI number for Ezra Margono is 1720647829. It was assigned to this individual provider in the NPPES registry on June 12, 2019.

Where is Ezra Margono located?

Ezra Margono practices at 55 Fruit St, Boston, MA 02114. The listed phone number is (617) 643-7860.

What is Ezra Margono's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Ezra Margono enrolled in Medicare?

Yes. Ezra Margono is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Ezra Margono affiliated with any hospitals?

According to CMS data, Ezra Margono is affiliated with Cambridge Health Alliance and Beth Israel Deaconess Medical Center.

When was this NPI record last updated?

The NPPES record for Ezra Margono was last updated on April 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.