Dr Ezra Theodore Fraser, MD - Medicare Diagnostic Radiology in Hermosa Beach, CA

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Dr Ezra Theodore Fraser, MD is a medicare enrolled "Radiology - Vascular & Interventional Radiology" physician in Hermosa Beach, California. He went to University Of California, San Francisco School Of Medicine and graduated in 2004 and has 20 years of diverse experience with area of expertise as Diagnostic Radiology. He is a member of the group practice Golden State Imaging Associates Inc, Sonoran Radiology Ltd, Chandler Radiology Associates Llc, Darin Rentz Do Pc and his current practice location is 421 30th St, Hermosa Beach, California. You can reach out to his office (for appointments etc.) via phone at (415) 902-5621.

Dr Ezra Theodore Fraser is licensed to practice in California (license number A112170) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1023240561.

Contact Information

Dr Ezra Theodore Fraser, MD
421 30th St,
Hermosa Beach, CA 90254-2131
(415) 902-5621
Not Available

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Physician's Profile

Full NameDr Ezra Theodore Fraser
GenderMale
SpecialityDiagnostic Radiology
Experience20 Years
Location421 30th St, Hermosa Beach, California
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Ezra Theodore Fraser attended and graduated from University Of California, San Francisco School Of Medicine in 2004
  NPI Data:
  • NPI Number: 1023240561
  • Provider Enumeration Date: 08/18/2009
  • Last Update Date: 10/16/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 3870761133
  • Enrollment ID: I20110713000140

Medical Identifiers

Medical identifiers for Dr Ezra Theodore Fraser such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1023240561NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2085R0202XRadiology - Diagnostic Radiology HOSPITAL LICENSE (Connecticut)Secondary
2085R0202XRadiology - Diagnostic Radiology A112170 (California)Secondary
2085R0204XRadiology - Vascular & Interventional Radiology A112170 (California)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Desert Regional Medical CenterPalm springs, CAHospital
Chandler Regional Medical CenterChandler, AZHospital
Nyc Health + Hospitals/coney IslandBrooklyn, NYHospital
Mercy Gilbert Medical CenterGilbert, AZHospital
Northwest Medical CenterTucson, AZHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Golden State Imaging Associates Inc1254761315223
Sonoran Radiology Ltd3375964505393
Chandler Radiology Associates Llc418360087739
Darin Rentz Do Pc731533385366

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. Dr Ezra Theodore Fraser allows following entities to bill medicare on his behalf.
Entity NameRenaissance Imaging Medical Associates Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1487608931
PECOS PAC ID: 7315841756
Enrollment ID: O20031126000257
Entity NameCentinela Radiology Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1861475352
PECOS PAC ID: 3476440215
Enrollment ID: O20040304000414
Entity NameDowney Radiology Associates
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1528012945
PECOS PAC ID: 6406802743
Enrollment ID: O20050329001369
Entity NameAdvanced Imaging Of South Bay, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003866914
PECOS PAC ID: 8628080520
Enrollment ID: O20060614000139
Entity NameRadadvantage A Professional Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1376719666
PECOS PAC ID: 2163597899
Enrollment ID: O20090917000455
Entity NameChandler Radiology Associates Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1386602076
PECOS PAC ID: 4183600877
Enrollment ID: O20131107000786
Entity NameGolden State Imaging Associates Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1144872052
PECOS PAC ID: 1254761315
Enrollment ID: O20200414001788
Entity NameSonoran Radiology Ltd
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1033745708
PECOS PAC ID: 3375964505
Enrollment ID: O20200701001467
Entity NameDarin Rentz Do Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1689321747
PECOS PAC ID: 7315333853
Enrollment ID: O20220408001009

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. Dr Ezra Theodore Fraser 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
Dr Ezra Theodore Fraser, MD
421 30th St,
Hermosa Beach, CA 90254-2131

Ph: (415) 902-5621		Dr Ezra Theodore Fraser, MD
421 30th St,
Hermosa Beach, CA 90254-2131

Ph: (415) 902-5621

Reviews and Comments


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Phone: 310-691-3103    
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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.