Active NPI
Jose R Estrellado, PA-C
- Medical Physician Assistant
- Moses Lake, WA
National Provider Identifier
1306871124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA10002543
- Practice address
- 840 E Hill Ave
Moses Lake, WA 98837-2238 - Phone
- (509) 765-0216
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA10002543 | WA | Primary |
Addresses
Primary practice location
840 E Hill Ave
Moses Lake, WA 98837-2238
Mailing address
820 N Chelan Ave
Wenatchee, WA 98801-2028
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 127395 | Other | WA | L&I |
| 1074335 | Medicaid | WA |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/R4/ | ||
| Direct Messaging Address | JESTRELLADO1749@EDIRECT.CHEHR.ORG |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA10002543 | WA | MD | Medical Physician Assistant |
Interoperability endpoints
- jestrellado1749@edirect.chehr.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655683200000",
"number": "1306871124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 N CHELAN AVE",
"city": "WENATCHEE",
"state": "WA",
"postal_code": "988012028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 E HILL AVE",
"city": "MOSES LAKE",
"state": "WA",
"postal_code": "988372238",
"telephone_number": "509-765-0216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTRELLADO",
"first_name": "JOSE",
"middle_name": "R",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2022-06-20",
"certification_date": "2022-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA10002543",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I",
"identifier": "127395",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1074335",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/R4/",
"affiliation": "N",
"address_1": "840 E Hill Ave",
"city": "Moses Lake",
"state": "WA",
"country_code": "US",
"postal_code": "988372238",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "JESTRELLADO1749@EDIRECT.CHEHR.ORG",
"affiliation": "N",
"address_1": "840 E Hill Ave",
"city": "Moses Lake",
"state": "WA",
"country_code": "US",
"postal_code": "988372238",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Moses Lake, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.