Individual provider Active NPI

Eshraq Al-Jaghbeer, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Milwaukee, WI
National Provider Identifier
1184897357
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
036116092 Issued in IL
Practice address
2801 W Kinnickinnic River Pkwy Ste 245
Milwaukee, WI 53215-3678
Phone
(414) 649-6780
Fax
(414) 649-6030
NPI assigned
Apr 9, 2008
Last updated
Oct 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 51511 WI
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036116092 IL Primary

Addresses

Primary practice location

2801 W Kinnickinnic River Pkwy Ste 245
Milwaukee, WI 53215-3678

Mailing address

2801 W Kinnickinnic River Pkwy
Ste 245
Milwaukee, WI 53215-3669
Phone (414) 649-6780

Other identifiers 1

IdentifierTypeStateIssuer
35232500MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ealjaghbeer23214@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240125001037 FL Practitioner - Endocrinology 6305912403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Institute of Endocrinology Diabetes Health and HormonesGroup PAC ID 8729300454, 32 clinicians

Practice addresses (Care Compare)

1241 Airport Rd
Suite M
Destin, FL 32541-2954
Phone (850) 460-7090

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036116092ILMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Institute of Endocrinology Diabetes Health and Hormones Endocrinology, Diabetes & Metabolism CurrentSince Jan 1, 2024 Accepting new patients

Locations

154 W Hickory Ave
Crestview, FL 32536
Phone (850) 460-7090

1241 Airport Rd
Ste M
Destin, FL 32541
Phone (850) 460-7090

633 E Baldwin Rd
Panama City, FL 32405
Phone (850) 522-5490

Interoperability endpoints

  • Direct secure messaging: ealjaghbeer23214@direct.myadvocateaurora.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1184897357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY",
            "address_2": "STE 245",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153669",
            "telephone_number": "414-649-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY STE 245",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153678",
            "telephone_number": "414-649-6780",
            "fax_number": "414-649-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-JAGHBEER",
        "first_name": "ESHRAQ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-09",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WI",
            "license": "51511",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036116092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35232500",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ealjaghbeer23214@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 245",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153678",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 245",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.