Individual provider Active NPI

Levi M Estrera, PT

  • Physical Therapist
  • CH, IL
National Provider Identifier
1639240476
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
021904 Issued in NY
Practice address
1135 S Delano CT E Apt 727
CH, IL 60605
Phone
(845) 591-1542
NPI assigned
Nov 13, 2006
Last updated
Sep 12, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 021904 NY Primary

Addresses

Primary practice location

1135 S Delano CT E Apt 727
CH, IL 60605

Mailing address

1135 South Delano Court East, Apt 727
Chicago, IL 60605
Phone (845) 591-1542

Other identifiers 1

IdentifierTypeStateIssuer
01620680MedicaidNY

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carmel Medical Care P.C. PastSince Apr 25, 2016 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.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1639240476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 SOUTH DELANO COURT EAST, APT 727",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60605",
            "telephone_number": "845-591-1542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 S DELANO CT E APT 727",
            "city": "CH",
            "state": "IL",
            "postal_code": "60605",
            "telephone_number": "845-591-1542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRERA",
        "first_name": "LEVI",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "021904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01620680",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.