Granwel Genio Esteban Jr., PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1004 Issued in TN

Practice address

1114 W Madison Ave
Athens, TN 37303-4150

Phone

(423) 745-1411

Fax

(865) 539-8008

NPI assigned

May 25, 2006

Last updated

Jul 28, 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

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in TN, FL, NC, VA, NY, IA6 enrollments

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 6

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospital Medicine Services of FL, LLCGroup PAC ID 9234596743, 513 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Allen Hospital Hospital, Waterloo, IA, CCN 160110

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gesteban1901474@nychhc.direct-ci.com

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 Medicine Services of FL, LLC

  • Hospitalist Physician
  • Aventura, FL
  • NPI 1710684857
  Medicare reassignment Care Compare group
• Emergency Medicine Associates, P.a.,P.C.

  • Internal Medicine Physician
  • Dulles, VA
  • NPI 1376917070
  Medicare reassignment NPD
• Henderson County Hospital Corporation

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Asheville, NC
  • NPI 1053782318
  Medicare reassignment NPD
• MVHS Inc

  dba Mohawk Valley Health System Inc

  • Family Medicine Physician
  • Utica, NY
  • NPI 1770690737
  Medicare reassignment NPD
• St Marys Healthcare

  • General Acute Care Hospital
  • Amsterdam, NY
  • NPI 1518926401
  Medicare reassignment NPD
• App of Tennessee Ed, PLLC

  • Emergency Medicine Physician
  • Maryville, TN
  • NPI 1003230236
  Medicare reassignment
• Tri-Cities Regional Emergency Physicians, PC

  • Emergency Medicine Physician
  • Johnson City, TN
  • NPI 1063950046
  Medicare reassignment
• Allen Memorial Hospital Corporation

  dba Allen Hospital

  • Women's Health Nurse Practitioner
  • Waterloo, IA
  • NPI 1891772927
  Medicare reassignment
• Buffalo Emergency Associates LLP

  • Emergency Medicine Physician
  • Williamsville, NY
  • NPI 1508816521
  Medicare reassignment
• Icahn School of Medicine at Mount Sinai

  dba Rehabilitation Fluoroscopy Medicine Department of Mount Sinai

  • Rehabilitation Practitioner
  • New York, NY
  • NPI 1477899078
  Medicare reassignment
• Icahn School of Medicine at Mount Sinai

  dba Mount Sinai Now

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1679083984
  Medicare reassignment
• Unitypoint Health - Marshalltown

  • Emergency Medicine Physician
  • Marshalltown, IA
  • NPI 1164957593
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Allen Memorial Hospital Corporation

  dba Allen Hospital

  • General Acute Care Hospital
  • Waterloo, IA
  • NPI 1336231091
  Care Compare affiliation

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1336195973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 634760",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452630001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 W MADISON AVE",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "373034150",
            "telephone_number": "423-745-1411",
            "fax_number": "865-539-8008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 N State Of Franklin Rd Ste 135",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046972",
            "country_code": "US",
            "telephone_number": "423-431-2350",
            "fax_number": "423-431-2372",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "410 N State Of Franklin Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046972",
            "country_code": "US",
            "telephone_number": "423-431-2477",
            "fax_number": "423-431-2478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESTEBAN",
        "first_name": "GRANWEL",
        "middle_name": "GENIO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "02673-01",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA1004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009941923",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "587885291A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4061134",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891012540",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00001071",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Athens, TN
• Providers in Athens, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.