Active NPI
Paul Byron Estenson, PHD
- Clinical Psychologist
- Ann Arbor, MI
National Provider Identifier
1184635534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301003813
- Practice address
- 2395 Oak Valley Dr
Suite 100
Ann Arbor, MI 48103-8943 - Phone
- (734) 995-5181
- Fax
- (734) 995-9011
- NPI assigned
- Aug 11, 2006
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301003813 | MI | Primary |
Addresses
Primary practice location
2395 Oak Valley Dr
Suite 100
Ann Arbor, MI 48103-8943
Mailing address
2395 Oak Valley Dr
Suite 100
Ann Arbor, MI 48103-8943
Phone (734) 995-5181
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 680H146640 | Other | MI | BCBS OF MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080924000042 | MI | Practitioner - Clinical Psychologist | 5991872582 | Practice locations: Ann Arbor, MI |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2395 Oak Valley Dr
Suite 100
Ann Arbor, MI 48103-9118
Phone (734) 995-5181
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301003813 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247011200000",
"number": "1184635534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2395 OAK VALLEY DR",
"address_2": "SUITE 100",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481038943",
"telephone_number": "734-995-5181",
"fax_number": "734-995-9011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2395 OAK VALLEY DR",
"address_2": "SUITE 100",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481038943",
"telephone_number": "734-995-5181",
"fax_number": "734-995-9011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTENSON",
"first_name": "PAUL",
"middle_name": "BYRON",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2009-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301003813",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MI",
"identifier": "680H146640",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2009; 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.