Individual provider Active NPI

Kendra E. Estep, PA-C

  • Physician Assistant
  • Winter Park, FL
National Provider Identifier
1255321071
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9114809 Issued in FL
Practice address
1925 Mizell Ave Ste 100
Winter Park, FL 32792-4155
Phone
(407) 894-4474
Fax
(407) 894-7032
NPI assigned
Oct 24, 2005
Last updated
Mar 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9114809 FL Primary
Physician Assistant 363A00000X MA051596 PA

Addresses

Primary practice location

1925 Mizell Ave Ste 100
Winter Park, FL 32792-4155

Mailing address

1925 Mizell Ave Ste 100
Winter Park, FL 32792-4155
Phone (407) 894-4474

Other identifiers 1

IdentifierTypeStateIssuer
103140803MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kestep7300@phsdirect.pinnaclehealth.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220207001970 FL Practitioner - Physician Assistant 1052306636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2100 Ocoee Apopka Rd
Apopka, FL 32703-9210

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA051596PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Mar 28, 2022 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Mar 28, 2022 Accepting new patients
Moffitt Heart and Vascular Group Inc. Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

1925 Mizell Ave
Ste 100
Winter Park, FL 32792
Phone (407) 539-2099

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kestep467575@adventhealth.direct-ci.com

Organizations & group practices 4

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 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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1255321071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 MIZELL AVE STE 100",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924155",
            "telephone_number": "407-894-4474",
            "fax_number": "407-894-7032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 MIZELL AVE STE 100",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924155",
            "telephone_number": "407-894-4474",
            "fax_number": "407-894-7032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTEP",
        "first_name": "KENDRA",
        "middle_name": "E.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-24",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114809",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051596",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103140803",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kestep7300@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "2808 Old Post Rd",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171103685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.