Edwar Jose Fernando Estupinian

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C6204 Issued in OR

Practice address

2225 Pacific Blvd SE
Albany, OR 97321-7907

Phone

(541) 286-5002

NPI assigned

Feb 21, 2018

Last updated

Jun 22, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Santiam Memorial HospitalGroup PAC ID 6103729751, 128 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Santiam Memorial Hospital

  • General Acute Care Hospital
  • Stayton, OR
  • NPI 1154302214
  Medicare reassignment Care Compare group NPD
• Arise Counseling Service, LLC. Dba Northlight Counseling

  • Clinical Social Worker
  • Eugene, OR
  • NPI 1447715834

  Professional

  NPD
• Santiam Memorial Hospital

  dba Santiam Health & Wellness Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Stayton, OR
  • NPI 1801787171
  NPD
• Santiam Memorial Hospital

  dba Santiam Podiatry Clinic

  • Podiatric Clinic/Center
  • Stayton, OR
  • NPI 1912413147
  NPD
• Conifer Wellness, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Corvallis, OR
  • NPI 1912551771
  NPD (past)

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1295236792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 PACIFIC BLVD SE STE 101",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973217903",
            "telephone_number": "541-286-5002",
            "fax_number": "541-246-8826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 PACIFIC BLVD SE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973217907",
            "telephone_number": "541-286-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTUPINIAN",
        "first_name": "EDWAR",
        "middle_name": "JOSE FERNANDO",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-21",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C6204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Ervin, RN
• Crystal Marie Eshelman
• Yesenia Espaillat
• Estes Enterprizes, LLC (Custom Eyes of Albany)
• Michael K Estes, O.D.
• Eudaemonia Behavioral Health LLC
• Hailey Amanda Eustice, MS, CCC-SLP
• Sara Evanko, PHARMD
• Blake Alexander Evans
• George Pete Evans

• Professional Counselor in Albany, OR
• Providers in Albany, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.

Verify at the official NPI Registry.