Individual provider Active NPI

Eduardo Estevis, PH. D

  • Clinical Neuropsychologist
  • Edinburg, TX
National Provider Identifier
1003977554
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
37532 Issued in TX
Practice address
2821 Michaelangelo Dr Ste 304
Edinburg, TX 78539-1405
Phone
(956) 362-8500
Fax
(956) 362-8505
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 37532 TX Primary

Addresses

Primary practice location

2821 Michaelangelo Dr Ste 304
Edinburg, TX 78539-1405

Mailing address

PO Box 749
Pharr, TX 78577-1614
Phone (956) 362-2171

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170805000222 TX Practitioner - Clinical Psychologist 8729359971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renaissance Medical FoundationGroup PAC ID 1153409867, 178 clinicians

Practice addresses (Care Compare)

5501 S McColl Rd
Edinburg, TX 78539-5503
Phone (956) 362-8677

Hospital & facility affiliations

  • Doctors Hosptal at Renaissance Hospital, Edinburg, TX, CCN 450869

Merit-based Incentive Payment System (MIPS)

Final score
98.1 of 100Reported as group
Quality
86
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
37532TXMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Renaissance Medical Foundation CurrentSince Aug 1, 2017 Accepting new patients

Locations

5501 S McColl Rd
Edinburg, TX 78539
Phone (956) 362-3300

2821 W Michaelangelo Dr
Ste 304
Edinburg, TX 78539
Phone (956) 362-8500

Organizations & group practices 1

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 2

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1003977554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785771614",
            "telephone_number": "956-362-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 MICHAELANGELO DR STE 304",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785391405",
            "telephone_number": "956-362-8500",
            "fax_number": "956-362-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTEVIS",
        "first_name": "EDUARDO",
        "credential": "PH. D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "37532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

Verify at the official NPI Registry.