Active NPI
Ezra Vail
- Pharmacist
- Worcester, MA
National Provider Identifier
1689512659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH1001133
- Practice address
- 14 W Boylston St
Worcester, MA 01605-1228 - Phone
- (508) 852-5344
- NPI assigned
- Mar 23, 2026
- Last updated
- Mar 23, 2026
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH1001133 | MA | Primary |
Addresses
Primary practice location
14 W Boylston St
Worcester, MA 01605-1228
Mailing address
14 W Boylston St
Worcester, MA 01605-1228
Phone (508) 852-5344
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH1001133 | MA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shaws Supermarkets Inc | Past | Accepting new patients | |
| Shaws Supermarkets Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Shaws Pharmacy #0624
- Community/Retail Pharmacy
- Worcester, MA
- NPI 1629024153
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1774224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774224000000",
"number": "1689512659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 W BOYLSTON ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016051228",
"telephone_number": "508-852-5344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 W BOYLSTON ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016051228",
"telephone_number": "508-852-5344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAIL",
"first_name": "EZRA",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2026-03-23",
"last_updated": "2026-03-23",
"certification_date": "2026-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH1001133",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.