Individual provider Active NPI

Jose Carlo Macalino Esteban, PA

  • Physician Assistant
  • Durham, NC
National Provider Identifier
1508417767
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-09369 Issued in NC
Practice address
4309 Emperor Blvd Ste 125
Durham, NC 27703-8068
Phone
(919) 941-0158
Fax
(919) 474-3130
NPI assigned
Sep 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-09369 NC Primary

Addresses

Primary practice location

4309 Emperor Blvd Ste 125
Durham, NC 27703-8068

Mailing address

4309 Emperor Blvd Ste 125
Durham, NC 27703-8068
Phone (919) 941-0158

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20200504001068 NC Practitioner - Physician Assistant 8628409869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Imperial Center Family Medicine and Immediate Care PLLCGroup PAC ID 2668639618, 6 clinicians

Practice addresses (Care Compare)

4309 Emperor Blvd
Suite 125
Durham, NC 27703-8068
Phone (919) 941-0158

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: jose.carlo.esteban.1@9649.direct.athenahealth.com
  • Direct secure messaging: josecarloesteban@vfmpa.allscriptsdirect.net

Organizations & group practices 1

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": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1508417767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4309 EMPEROR BLVD STE 125",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277038068",
            "telephone_number": "919-941-0158",
            "fax_number": "919-474-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 EMPEROR BLVD STE 125",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277038068",
            "telephone_number": "919-941-0158",
            "fax_number": "919-474-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTEBAN",
        "first_name": "JOSE CARLO",
        "middle_name": "MACALINO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-27",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.