Individual provider Active NPI

Cynthia A Esteban, NP

  • Pediatric Nurse Practitioner
  • Providence, RI
National Provider Identifier
1407895048
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN00198 Issued in RI
Practice address
593 Eddy St
Providence, RI 02903-4923
Phone
(401) 444-6195
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 242411 MA
Pediatric Nurse Practitioner 363LP0200X 37233 RI
Pediatric Nurse Practitioner 363LP0200X APRN00198 RI Primary

Addresses

Primary practice location

593 Eddy St
Providence, RI 02903-4923

Mailing address

340 Wood Rd
Braintree, MA 02184-2401
Phone (617) 726-8707

Other practice location 1

340 Wood Rd
Braintree, MA 02184-2401
Phone (617) 726-8707

Other identifiers 1

IdentifierTypeStateIssuer
CE51834MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040121000249 RI Practitioner - Nurse Practitioner 0547162679 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
37233RIMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital CurrentSince Feb 8, 2021 Accepting new patients
Rhode Island Hospital CurrentSince Feb 8, 2021 Accepting new patients
Lifespan Corporation Current Accepting new patients
Rhode Island Hospital Past Accepting new patients

Locations

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

1 Hoppin St
Providence, RI 02903
Phone (401) 444-3996

593 Eddy St
Providence, RI 02903

593 Eddy St
Ste 5
Providence, RI 02903
Phone (401) 444-3996

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

Interoperability endpoints

  • Direct secure messaging: cesteban8686@brownhealth.medalliesdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1407895048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 WOOD RD",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021842401",
            "telephone_number": "617-726-8707",
            "fax_number": "617-724-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-6195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "340 Wood Rd",
            "address_purpose": "LOCATION",
            "city": "Braintree",
            "state": "MA",
            "postal_code": "021842401",
            "country_code": "US",
            "telephone_number": "617-726-8707",
            "fax_number": "617-724-2803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESTEBAN",
        "first_name": "CYNTHIA",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "242411",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "RI",
            "license": "37233",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "RI",
            "license": "APRN00198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CE51834",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.