Individual provider Active NPI

Victor Denoga Estacio, MD

  • Hospitalist Physician
  • Seattle, WA
National Provider Identifier
1063732782
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD60329784 Issued in WA
Practice address
747 Broadway
Seattle, WA 98122-4379
Phone
(206) 386-6000
Fax
(206) 215-6364
NPI assigned
Jun 4, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD60329784 WA
Hospitalist Physician 208M00000X MD60329784 WA Primary

Addresses

Primary practice location

747 Broadway
Seattle, WA 98122-4379

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other identifiers 1

IdentifierTypeStateIssuer
1063732782MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130730000194 WA Practitioner - HospitalistPractitioner - Internal Medicine 7113168410 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians

Practice addresses (Care Compare)

500 17TH Ave
Seattle, WA 98122-5711
Phone (206) 320-2000

747 Broadway
Seattle, WA 98122-4379
Phone (206) 386-6000

Hospital & facility affiliations

  • Swedish Medical Center Hospital, Seattle, WA, CCN 500027
  • Swedish Medical Center / Cherry Hill Hospital, Seattle, WA, CCN 500025

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Sep 15, 2021 Accepting new patients
Valley Medical Group-Renton Internal Medicine CurrentSince Feb 21, 2017 Accepting new patients
Swedish Health Services Internal Medicine CurrentSince Dec 6, 2021 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Sep 15, 2021 Accepting new patients
Swedish Health Services Past Accepting new patients
Swedish Health Services Past Accepting new patients

Locations

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800

11511 NE 10th St
Hunts Point, WA 98004
Phone (425) 502-3000

400 S 43rd St
Renton, WA 98055
Phone (425) 228-3450

4011 Talbot Rd S
Ste 460
Renton, WA 98055
Phone (425) 251-5110

4011 Talbot Rd S
Ste 500
Renton, WA 98055
Phone (425) 251-5110

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: vestacio3931435@ghc.direct-ci.net

Organizations & group practices 6

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": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1063732782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 BROADWAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224379",
            "telephone_number": "206-386-6000",
            "fax_number": "206-215-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTACIO",
        "first_name": "VICTOR",
        "middle_name": "DENOGA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-04",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60329784",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "MD60329784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063732782",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.