NPIMap

Individual provider Active NPI

Estelle Ostgard, MD

  • Family Medicine Physician
  • Keshena, WI
National Provider Identifier
1518213115
Registry record updated Nov 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
64387 Issued in WI
Practice address
W3275 Wolf River Road
Menominee Tribal Clinic
Keshena, WI 54135-0970
Phone
(715) 799-3361
Fax
(715) 799-3099
NPI assigned
Aug 1, 2012
Last updated
Nov 3, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X RL12397 ND
Family Medicine Physician 207Q00000X 64387 WI Primary

Addresses

Primary practice location

W3275 Wolf River Road
Menominee Tribal Clinic
Keshena, WI 54135-0970

Mailing address

PO Box 970
Menominee Tribal Clinic
Keshena, WI 54135-0970
Phone (715) 799-3361

Other identifiers 2

IdentifierTypeStateIssuer
12083MedicaidND
100047625MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151008001912 WI Practitioner - Family Practice 3678795143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Sanford School of Medicine of University of South Dakota, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

W3275 Wolf River Dr
Keshena, WI 54135-9202
Phone (715) 799-3361

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64387WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Menominee Indian Tribe of Wisconsin Family Medicine CurrentSince Sep 2, 2015 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1518213115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970",
            "address_2": "MENOMINEE TRIBAL CLINIC",
            "city": "KESHENA",
            "state": "WI",
            "postal_code": "541350970",
            "telephone_number": "715-799-3361",
            "fax_number": "715-799-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W3275 WOLF RIVER ROAD",
            "address_2": "MENOMINEE TRIBAL CLINIC",
            "city": "KESHENA",
            "state": "WI",
            "postal_code": "541350970",
            "telephone_number": "715-799-3361",
            "fax_number": "715-799-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTGARD",
        "first_name": "ESTELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-01",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "RL12397",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "64387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12083",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100047625",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keshena, WI

Sources for this page

Verify at the official NPI Registry.