Individual provider Active NPI

Jaime Estrada, MD

  • Pediatric Hematology & Oncology Physician
  • San Antonio, TX
National Provider Identifier
1396792065
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
G2361 Issued in TX
Practice address
4410 Medical Dr
Ste 540
San Antonio, TX 78229-3755
Phone
(210) 575-6240
Fax
(210) 575-6280
NPI assigned
May 28, 2006
Last updated
Apr 4, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X G2361 TX
Pediatrics Physician 208000000X G2361 TX
Pediatric Hematology & Oncology Physician 2080P0207X G2361 TX Primary

Addresses

Primary practice location

4410 Medical Dr
Ste 540
San Antonio, TX 78229-3755

Mailing address

8109 Fredericksburg Rd
Physician Practice Services
San Antonio, TX 78229-3311
Phone (210) 575-6240

Other identifiers 3

IdentifierTypeStateIssuer
133046612MedicaidTX
8BX389OtherTXBCBS
133046613OtherTXCSHCN

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G2361TXMDHematology (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Institute of Medicine and Surgery Pediatrics Past Accepting new patients
Methodist Physician Practices, PLLC Pediatric Hematology-Oncology Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16700/brand/2/csg/1/fhir/r4
  • Direct secure messaging: jaime.estrada@hca7.eclinicaldirectplus.com

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": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333497600000",
    "number": "1396792065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8109 FREDERICKSBURG RD",
            "address_2": "PHYSICIAN PRACTICE SERVICES",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293311",
            "telephone_number": "210-575-6240",
            "fax_number": "210-575-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 MEDICAL DR",
            "address_2": "STE 540",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293755",
            "telephone_number": "210-575-6240",
            "fax_number": "210-575-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "JAIME",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2012-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "TX",
            "license": "G2361",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "G2361",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "TX",
            "license": "G2361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133046612",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8BX389",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "133046613",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.