Ezequiel R Mora, APRN FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.025250 Issued in IL

Practice address

954 W State St
Sycamore, IL 60178-1335

Phone

(815) 895-9144

NPI assigned

Apr 26, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Anthony Medical Center Hospital, Rockford, IL, CCN 140233
• Northwestern Medicine Kishwaukee Hospital Hospital, Dekalb, IL, CCN 140286

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Edward Health Ventures

  • Multi-Specialty Clinic/Center
  • Bolingbrook, IL
  • NPI 1962452912
  Medicare reassignment NPD
• Edward Health Ventures

  • Family Medicine Physician
  • Naperville, IL
  • NPI 1154371185
  NPD
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

• Kishwaukee Community Hospital

  dba Northwestern Medicine Kishwaukee Hospital

  • General Acute Care Hospital
  • Dekalb, IL
  • NPI 1669534517
  Care Compare affiliation
• Saint Anthony Medical Center

  dba OSF Saint Anthony Medical Center

  • General Acute Care Hospital
  • Rockford, IL
  • NPI 1790739977
  Care Compare affiliation

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1912641879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1373 OMEGA CIRCLE DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601155832",
            "telephone_number": "815-501-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 W STATE ST",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601781335",
            "telephone_number": "815-895-9144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORA",
        "first_name": "EZEQUIEL",
        "middle_name": "R",
        "credential": "APRN FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-26",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "041.408204",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.025250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Misoles
• Jehangir P Mistry, MD
• Erin Mitchell, LCSW
• Kristin A Mock, MD
• Jessica Moede, APRN
• Ketan N Morker, M.D.
• Jacqueline Morrey, LCSW MASTERS
• Brianna Morsch, PTA
• Laura L Mosier
• Joellen Moss, RN

• Family Nurse Practitioner in Sycamore, IL
• Providers in Sycamore, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.