DR. KENNETH E EZIMOHA MD
NPI 1760377071
Internal Medicine in Whitestone, NY

Active since June 09, 2025PECOS EnrolledAccepts Medicare Assignment
15715 19TH AVE, WHITESTONE, NY 11357(718) 746-0408 Get Directions Write a Review

NPPES record last updated: June 23, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 23, 2025, Jun 9, 2025 (2 updates tracked since 2025).

About Dr. Kenneth E Ezimoha Md NPPES

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

DR. KENNETH E EZIMOHA MD (NPI 1760377071) is an individual internal medicine provider in Whitestone, New York, licensed in New York (P135556) and active in the NPI registry since June 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2004).

NPPES Registry Identity

NPI1760377071
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. KENNETH E EZIMOHACredential: MD
Location Address15715 19TH AVEWhitestone, NY 11357-3820
Mailing Address15715 19th AveWhitestone, NY 11357-3820
Sole ProprietorYes
Medical School CMSOtherGraduated 2004
Enumeration DateJune 9, 2025
Last NPPES UpdateJune 23, 20252 updates tracked since enumeration
NPPES CertifiedJune 23, 2025
NPI 1760377071 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in NY · P135556
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

15715 19TH AVE, Whitestone, NY 11357

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

Dr. Kenneth E Ezimoha 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 ID4082125950
PECOS Enrollment IDI20250617003125
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11357 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
$153.13 typical visit price
range $67.00 – $201.98
Typical copayment $38.28 (range $16.75 – $50.49)
Most-billed visit code 99204
Established Patient
$116.96 typical visit price
range $21.62 – $163.52
Typical copayment $29.24 (range $5.40 – $40.88)
Most-billed visit code 99214
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 10

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

Speech-Language Pathologist
15715 19TH AVE
WHITESTONE, NY 11357
Internal Medicine
15715 19TH AVE
WHITESTONE, NY 11357
Physical Therapy Assistant
15715 19TH AVE
WHITESTONE, NY 11357
Clinic/Center (Physical Therapy)
15715 19TH AVE
WHITESTONE, NY 11357
Physical Therapy Assistant
15715 19TH AVE
WHITESTONE, NY 11357
Home Health
15715 19TH AVE
WHITESTONE, NY 11357
Physical Therapy Assistant
15715 19TH AVE
WHITESTONE, NY 11357
Physical Therapy Assistant
15715 19TH AVE
FLUSHING, NY 11357

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 Kenneth Ezimoha's NPI number?

The NPI number for Kenneth Ezimoha is 1760377071. It was assigned to this individual provider in the NPPES registry on June 9, 2025.

Where is Kenneth Ezimoha located?

Kenneth Ezimoha practices at 15715 19th Ave, Whitestone, NY 11357. The listed phone number is (718) 746-0408.

What is Kenneth Ezimoha's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Kenneth Ezimoha enrolled in Medicare?

Yes. Kenneth Ezimoha 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.

When was this NPI record last updated?

The NPPES record for Kenneth Ezimoha was last updated on June 23, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.