NPIMap

Individual provider Active NPI

Jeremy R. Estrada, MD

  • Cardiovascular Disease Physician
  • Chicago, IL
National Provider Identifier
1225447725
Registry record updated Apr 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036.130657 Issued in IL
Practice address
5841 S Maryland Ave # Mc5841
Chicago, IL 60637-1447
Phone
(773) 702-1000
NPI assigned
Aug 8, 2014
Last updated
Apr 19, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036.130657 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave # Mc5841
Chicago, IL 60637-1447

Mailing address

96 Campus Dr
Scarborough, ME 04074-7163

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, NH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161026002708 ME Practitioner - Cardiovascular Disease (Cardiology) 2466759923 Reassigns benefits to 3 organizations
I20190501001361 NH Practitioner - Cardiovascular Disease (Cardiology) 2466759923

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians
St Marys Regional Medical CenterGroup PAC ID 0042107120, 192 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Biddeford, ME 04005-9422
Phone (207) 282-4270

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

93 Campus Ave
Lewiston, ME 04240-6030
Phone (207) 777-4420

96 Campus Dr
Scarborough, ME 04074-7163
Phone (207) 885-9905

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting32
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.130657ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Sep 1, 2016 Accepting new patients
Maine Medical Partners Current Accepting new patients
Maine Medical Partners CurrentSince Sep 1, 2016 Accepting new patients
Maine Medical Partners Cardiovascular Disease CurrentSince Sep 1, 2016 Accepting new patients
St. Mary's Regional Medical Center CurrentSince Aug 1, 2017 Accepting new patients
Memorial Hospital Current Accepting new patients
Mainehealth CurrentSince Sep 1, 2016 Accepting new patients
Mainehealth Current Accepting new patients
St. Mary's Regional Medical Center CurrentSince Aug 1, 2017 Accepting new patients
Mainehealth Past Accepting new patients

Locations

93 Campus Ave
Lewiston, ME 04240
Phone (207) 755-3715

93 Campus Ave
#I2
Lewiston, ME 04240
Phone (207) 777-4459

99 Campus Ave
Ste 301
Lewiston, ME 04240
Phone (207) 777-4320

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

887 Congress St
Ste 200
Portland, ME 04102
Phone (207) 771-5549

96 Campus Dr
Scarborough, ME 04074
Phone (207) 885-9905

96 Campus Dr
Ste 1
Scarborough, ME 04074
Phone (207) 396-5611

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

3073 White Mountain Hwy
North Conway, NH 03860
Phone (603) 356-5472

Interoperability endpoints

  • Direct secure messaging: jestrada143823@direct.mmc.mainehealth.org

Organizations & group practices 10

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 42

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 42

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555632000000",
    "number": "1225447725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 CAMPUS DR",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # MC5841",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447",
            "telephone_number": "773-702-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "JEREMY",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-08",
        "last_updated": "2019-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036.130657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.