NPIMap

Individual provider Active NPI

Benedicto M Estoesta, M.D.

  • Adult Medicine Physician
  • Valley Springs, CA
National Provider Identifier
1649451071
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
A49318 Issued in CA
Practice address
55 S Highway 26 Ste 1
Valley Springs, CA 95252-8422
Phone
(209) 772-8906
Fax
(209) 772-8950
NPI assigned
Nov 14, 2007
Last updated
Nov 14, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X A49318 CA
Adult Medicine Physician 207QA0505X A49318 CA Primary

Addresses

Primary practice location

55 S Highway 26 Ste 1
Valley Springs, CA 95252-8422

Mailing address

55 S Highway 26 Ste 1
Valley Springs, CA 95252-8422
Phone (209) 772-8906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040206000621 CA Practitioner - Family Practice 1456244995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

55 S Hwy 26
Suite 1
Valley Springs, CA 95252-8422
Phone (209) 772-8906

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions15
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Benedicto M. Estoesta M.D. Inc Adult Medicine CurrentSince Oct 1, 2003 Accepting new patients
El Camino Hospital Past Accepting new patients
Mark Twain Medical Center Past Accepting new patients

Locations

55 S Highway 26
Ste 1
Valley Springs, CA 95252
Phone (209) 772-8906

Interoperability endpoints

  • Direct secure messaging: centerforintegrativemedicine2.benedictoestoesta@128306.advancedmd-direct.com

Organizations & group practices 3

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 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194998400000",
    "number": "1649451071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 S HIGHWAY 26 STE 1",
            "city": "VALLEY SPRINGS",
            "state": "CA",
            "postal_code": "952528422",
            "telephone_number": "209-772-8906",
            "fax_number": "209-772-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 S HIGHWAY 26 STE 1",
            "city": "VALLEY SPRINGS",
            "state": "CA",
            "postal_code": "952528422",
            "telephone_number": "209-772-8906",
            "fax_number": "209-772-8950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTOESTA",
        "first_name": "BENEDICTO",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "A49318",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "A49318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Springs, CA

Sources for this page

Verify at the official NPI Registry.