Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Ezra Gillego, RPA-C

Individual provider Surgical Physician Assistant · NPI 1407061393

Mr. Ezra Gillego, RPA-C is a Physician Assistant in New York, New York. Qualified in 2006, 20 years ago. Practices with Samaritan Medical Services PC, a 336-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
20
Licensed in
NY
In the registry since
2007
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Practice location Address checks out

1ST Ave 16th St
New York, NY 10003
Phone: (212) 420-2953
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 011163 (NY)

Record details

NPI number1407061393
Entity typeIndividual (Type 1)
GenderMale
Credentials RPA-C
Sole proprietorNo
NPI enumeratedMay 13, 2007
Last updated in NPPESMarch 11, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Samaritan Medical Services Pc — 336 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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