Individual provider Active NPI

Nicole J Estock, MD

  • Pediatrics Physician
  • Pittsburgh, PA
National Provider Identifier
1295720068
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD440034 Issued in PA
Practice address
320 E North Ave
Pittsburgh, PA 15212-4756
Phone
(412) 359-4081
Fax
(412) 359-3663
NPI assigned
Sep 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 23109 SC
Pediatrics Physician 208000000X MD440034 PA Primary

Addresses

Primary practice location

320 E North Ave
Pittsburgh, PA 15212-4756

Mailing address

320 E North Ave
Pittsburgh, PA 15212-4756
Phone (412) 359-4081

Other identifiers 2

IdentifierTypeStateIssuer
T72800MedicaidSC
1026513540001MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nestock10802@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20111116000558 PA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7012181696

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: nestock10802@direct.ahn.org

NPI Registry JSON

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1295720068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E NORTH AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124756",
            "telephone_number": "412-359-4081",
            "fax_number": "412-359-3663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E NORTH AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124756",
            "telephone_number": "412-359-4081",
            "fax_number": "412-359-3663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTOCK",
        "first_name": "NICOLE",
        "middle_name": "J",
        "name_prefix": "Miss",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-16",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "23109",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD440034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T72800",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1026513540001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nestock10802@direct.ahn.org",
            "affiliation": "N",
            "address_1": "320 E North Ave",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152124756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.