Individual provider Active NPI

Dolores A Estrada-Garcia, MD

  • Hematology & Oncology Physician
  • Decatur, IL
National Provider Identifier
1316950033
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
036105214 Issued in IL
Practice address
210 W. McKinley Ave
Suite 1
Decatur, IL 62526
Phone
(217) 876-6600
Fax
(217) 876-6606
NPI assigned
Aug 14, 2006
Last updated
May 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 036105214 IL Primary

Addresses

Primary practice location

210 W. McKinley Ave
Suite 1
Decatur, IL 62526

Mailing address

PO Box 25228
Decatur, IL 62525-5228
Phone (217) 329-3232

Other identifiers 1

IdentifierTypeStateIssuer
036105214MedicaidIL

Other names 1

  • Dolores Aquino Estrada Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20060324000253 IL Practitioner - Hematology/OncologyPractitioner - Internal Medicine 4981612470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Saint Louis University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

210 W McKinley Ave
Suite 1
Decatur, IL 62526-5858
Phone (217) 877-9442

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Decatur Memorial Hospital Past Accepting new patients
Logan General Hospital LLC Past Accepting new patients

Organizations & group practices 3

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1316950033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25228",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625255228",
            "telephone_number": "217-329-3232",
            "fax_number": "217-233-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W. MCKINLEY AVE",
            "address_2": "SUITE 1",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "62526",
            "telephone_number": "217-876-6600",
            "fax_number": "217-876-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRADA-GARCIA",
        "first_name": "DOLORES",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036105214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036105214",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOLORES",
            "last_name": "ESTRADA",
            "middle_name": "AQUINO",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.