Active NPI
Michael E. Estess, M. D.
- Psychiatry Physician
- Boise, ID
National Provider Identifier
1003030099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- M-3173
- Practice address
- 1471 Shoreline Dr
Suite 119
Boise, ID 83702-6879 - Phone
- (208) 345-2630
- Fax
- (208) 345-6504
- NPI assigned
- Apr 12, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | M-3173 | ID | Primary |
Addresses
Primary practice location
1471 Shoreline Dr
Suite 119
Boise, ID 83702-6879
Mailing address
1471 Shoreline Dr
Suite 119
Boise, ID 83702-6879
Phone (208) 345-2630
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DG399 | Other | ID | BLUE CROSS |
| 000010003612 | Other | ID | BLUE SHIELD |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-3173 | ID | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael E. Estess, M. D. Chartered | Past | Accepting new patients | |
| Michael E. Estess | 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.
-
- Neurology Physician
- Boise, ID
- NPI 1609078104
-
- Preferred Provider Organization
- Boise, ID
- NPI 1558585455
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003030099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1471 SHORELINE DR",
"address_2": "SUITE 119",
"city": "BOISE",
"state": "ID",
"postal_code": "837026879",
"telephone_number": "208-345-2630",
"fax_number": "208-345-6504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1471 SHORELINE DR",
"address_2": "SUITE 119",
"city": "BOISE",
"state": "ID",
"postal_code": "837026879",
"telephone_number": "208-345-2630",
"fax_number": "208-345-6504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTESS",
"first_name": "MICHAEL",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "M. D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "ID",
"license": "M-3173",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "DG399",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "000010003612",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.