Active NPI
Anthony A Estrada
- Community Health Worker
- Bend, OR
National Provider Identifier
1649040411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- THW000110261
- Practice address
- 2065 NE Tucson Way Apt 110
Bend, OR 97701-5182 - Phone
- (541) 383-3005
- Fax
- (541) 383-1883
- NPI assigned
- Jan 3, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | THW000110261 | OR | Primary |
Addresses
Primary practice location
2065 NE Tucson Way Apt 110
Bend, OR 97701-5182
Mailing address
PO Box 4228
Portland, OR 97208-4228
Phone (541) 383-3005
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| THW000110261 | OR | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704240000000",
"number": "1649040411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4228",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972084228",
"telephone_number": "541-383-3005",
"fax_number": "541-383-1883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2065 NE TUCSON WAY APT 110",
"city": "BEND",
"state": "OR",
"postal_code": "977015182",
"telephone_number": "541-383-3005",
"fax_number": "541-383-1883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTRADA",
"first_name": "ANTHONY",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-01-03",
"last_updated": "2024-01-03",
"certification_date": "2024-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "OR",
"license": "THW000110261",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.