Active NPI
Gladys Estrada, M.D.
- Family Medicine Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 125056228
- Practice address
- 5359 W Fullerton Ave
Chicago, IL 60639-1450 - Phone
- (708) 763-2369
- NPI assigned
- Jun 8, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 125056228 | IL | Primary |
Addresses
Primary practice location
5359 W Fullerton Ave
Chicago, IL 60639-1450
Mailing address
5359 W Fullerton Ave
Chicago, IL 60639-1450
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Georgetown University School of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Brickhill Ave
Portland, ME 04106-1999
Phone (207) 874-2141
180 Park Ave
Portland, ME 04102-2957
Phone (207) 874-2141
Hospital & facility affiliations
- Northern Light Mercy Hospital
- Mainehealth Maine Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125056228 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Portland Community Health Center | Current | Accepting new patients | |
| Portland Community Health Center | Current | Accepting new patients | |
| Portland Community Health Center | Past | Accepting new patients |
Locations
180 Park Ave
Portland, ME 04102
Phone (207) 772-3703
180 Park Ave
Ste 1
Portland, ME 04102
Phone (207) 828-2101
100 Brickhill Ave
South Portland, ME 04106
Phone (207) 773-1728
100 Brickhill Ave
Ste 301
South Portland, ME 04106
Phone (207) 841-2141
Interoperability endpoints
- gladys.estrada.p1@direct.portlandchc.nextgenshare.com
Organizations & group practices 3
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.
-
- Federally Qualified Health Center (FQHC)
- Portland, ME
- NPI 1609120856
-
- Federally Qualified Health Center (FQHC)
- Portland, ME
- NPI 1982338240
-
- Federally Qualified Health Center (FQHC)
- Portland, ME
- NPI 1447694344
Hospital & facility affiliations 38
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Scarborough, ME
- NPI 1053647024
-
- General Acute Care Hospital
- Portland, ME
- NPI 1346267879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301961600000",
"number": "1124254800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5359 W FULLERTON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606391450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5359 W FULLERTON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606391450",
"telephone_number": "708-763-2369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTRADA",
"first_name": "GLADYS",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-08",
"last_updated": "2011-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "125056228",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; 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.