Individual provider Active NPI

Estela Odaniell, M.D.

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Corpus Christi, TX
National Provider Identifier
1386714897
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
L9402 Issued in TX
Practice address
3533 S Alameda St
Corpus Christi, TX 78411-1721
Phone
(361) 694-5100
NPI assigned
Nov 9, 2006
Last updated
Jan 10, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X L9402 TX Primary

Addresses

Primary practice location

3533 S Alameda St
Corpus Christi, TX 78411-1721

Mailing address

3435 S Alameda St
Corpus Christi, TX 78411-1728
Phone (361) 855-8201

Other identifiers 2

IdentifierTypeStateIssuer
165780101MedicaidTX
81654SOtherTXBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20130110000508 TX Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 8022260777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Emergency Medicine
Education
Texas Tech University Health Science Center School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nueces Emergency Medicine Associates PAGroup PAC ID 4284955501, 8 clinicians

Practice addresses (Care Compare)

3533 S Alameda St
Corpus Christi, TX 78411-1721
Phone (361) 694-5000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nueces Emergency Medicine Associates PA Pediatric Emergency Medicine CurrentSince May 1, 2015 Accepting new patients
Coastal Bend Emergency Services Association PastSince Sep 18, 2012 Accepting new patients

Locations

3533 S Alameda St
Corpus Christi, TX 78411
Phone (361) 694-5445

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1386714897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 S ALAMEDA ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784111728",
            "telephone_number": "361-855-8201",
            "fax_number": "361-855-5381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3533 S ALAMEDA ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784111721",
            "telephone_number": "361-694-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODANIELL",
        "first_name": "ESTELA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "TX",
            "license": "L9402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165780101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "81654S",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.