Ezequiel R Mora, APRN FNP-BC in Sycamore, IL - Medicare Nurse Practitioner

Ezequiel R Mora, APRN FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Sycamore, Illinois. His current practice location is 954 W State St, Sycamore, Illinois. You can reach out to his office (for appointments etc.) via phone at (815) 895-9144.

Ezequiel R Mora is licensed to practice in Illinois (license number 209.025250) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1912641879.

Contact Information

	Ezequiel R Mora, APRN FNP-BC
	954 W State St, Sycamore, IL 60178-1335
	(815) 895-9144
	Not Available

Map and Direction

Provider's Profile

Full Name	Ezequiel R Mora
Gender	Male
Speciality	Nurse Practitioner - Family
Location	954 W State St, Sycamore, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1912641879
Provider Enumeration Date: 04/26/2022
Last Update Date: 05/27/2022

Medicare PECOS Information:

PECOS PAC ID: 5991188153
Enrollment ID: I20220821000060

Medical Identifiers

Medical identifiers for Ezequiel R Mora such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1912641879	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	041.408204 (Illinois)	Secondary
363LF0000X	Nurse Practitioner - Family	209.025250 (Illinois)	Primary

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. Ezequiel R Mora allows following entities to bill medicare on his behalf.

Entity Name	Edward Health Ventures
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1962452912 PECOS PAC ID: 4284531484 Enrollment ID: O20031216000616

Entity Name	Osf Multi-specialty Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1922445527 PECOS PAC ID: 3678889789 Enrollment ID: O20150904000279

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. Ezequiel R Mora 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 Address	Practice Location Address
Ezequiel R Mora, APRN FNP-BC 1373 Omega Circle Dr, Dekalb, IL 60115-5832 Ph: (815) 501-5393	Ezequiel R Mora, APRN FNP-BC 954 W State St, Sycamore, IL 60178-1335 Ph: (815) 895-9144

Reviews and Comments

Nurse Practitioner Nurses in Sycamore, IL

Mrs. Jessica R Anderson, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 165 E Plank Rd, Sycamore, IL 60178 Phone: 844-599-3700
Deepak Sharma, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 437 W State St Apt 101, Sycamore, IL 60178 Phone: 630-550-1058 Fax: 815-205-4545
Megan Fish, APRN, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1850 Gateway Dr Ste 103, Sycamore, IL 60178 Phone: 815-758-8671 Fax: 815-756-4892
Mrs. Teresa Kay Farris, APN-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1850 Gateway Drive, Sycamore, IL 60178 Phone: 815-758-8671 Fax: 815-758-7298
Jennifer Tarvestad, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1850 Gateway Dr, Sycamore, IL 60178 Phone: 815-758-8671 Fax: 815-756-4892
Nicole Rodiek, APRN, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2127 Midlands Ct Unit 203, Sycamore, IL 60178 Phone: 815-758-8106 Fax: 815-758-8108
Ms. Linda Ann Myers, APN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 760 Foxpointe Dr, Sycamore, IL 60178 Phone: 815-748-8334 Fax: 815-748-1587

Ezequiel R Mora, APRN FNP-BC - Medicare Nurse Practitioner in Sycamore, IL