Individual provider Active NPI

Ezequiel De Leon, NP

  • Nurse Practitioner
  • Milford, MA
National Provider Identifier
1124764238
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2337287 Issued in MA
Practice address
117 Water St
Milford, MA 01757-3036
Phone
(508) 478-4500
Fax
(508) 478-5235
NPI assigned
May 11, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2337287 MA Primary

Addresses

Primary practice location

117 Water St
Milford, MA 01757-3036

Mailing address

455A Lake Ave
Worcester, MA 01604-1366
Phone (774) 287-0033

Other practice location 1

1280 W Central St Ste 301
Franklin, MA 02038-3110
Phone (508) 528-2700

Other identifiers 1

IdentifierTypeStateIssuer
110091343AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220602001381 MA Practitioner - Nurse Practitioner 2264810217 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Massachusetts Medical School, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

117 Water St
Milford, MA 01757-3036
Phone (508) 478-4500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2337287MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Milford Regional Physician Group, Inc. CurrentSince Jun 13, 2022 Accepting new patients
Umass Memorial Medical Group Inc Nurse Practitioner CurrentSince Oct 1, 2025 Accepting new patients
Milford Regional Physician Group, Inc. CurrentSince Jun 13, 2022 Accepting new patients
Milford Regional Physician Group, Inc. Current Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Oct 1, 2025 Accepting new patients

Locations

1280 W Central St
Ste 301
Franklin, MA 02038
Phone (508) 528-2700

9 Industrial Rd
Ste 5
Milford, MA 01757
Phone (508) 473-1480

117 Water St
Milford, MA 01757
Phone (508) 478-4500

308 Main St
Milford, MA 01757
Phone (508) 478-0555

100 Medway Rd
Ste 401
Milford, MA 01757
Phone (508) 634-7338

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: ezequiel.de.leon.1@24697.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1124764238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455A LAKE AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016041366",
            "telephone_number": "774-287-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 WATER ST",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017573036",
            "telephone_number": "508-478-4500",
            "fax_number": "508-478-5235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1280 W Central St Ste 301",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "MA",
            "postal_code": "020383110",
            "country_code": "US",
            "telephone_number": "508-528-2700",
            "fax_number": "508-528-5759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LEON",
        "first_name": "EZEQUIEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-11",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2337287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110091343A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, MA

Sources for this page

Verify at the official NPI Registry.