Evodio Hector Estrada

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3129 Issued in OK

Practice address

2130 SW 59TH St
Oklahoma City, OK 73119-7025

Phone

(403) 303-7555

Fax

(405) 561-5615

NPI assigned

Jan 31, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oak Street Health Physicians Group of Oklahoma, LLCGroup PAC ID 1355746769, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: eestrada376223@direct.ochin.org

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.

• Oak Street Health Physicians Group of Oklahoma, LLC

  • Primary Care Clinic/Center
  • Oklahoma City, OK
  • NPI 1538742051
  Medicare reassignment Care Compare group
• Oak Street Health of Georgia PC

  • Primary Care Clinic/Center
  • Stone Mountain, GA
  • NPI 1588258024
  NPD (past)

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

{
    "created_epoch": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1659902385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740020",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740020",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 SW 59TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731197025",
            "telephone_number": "403-303-7555",
            "fax_number": "405-561-5615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 Straka Ter",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731392544",
            "country_code": "US",
            "telephone_number": "405-632-6688",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7521 SE 15th St",
            "address_purpose": "LOCATION",
            "city": "Midwest City",
            "state": "OK",
            "postal_code": "731105425",
            "country_code": "US",
            "telephone_number": "405-453-8004",
            "fax_number": "405-561-4857",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1538 N Lewis Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741102535",
            "country_code": "US",
            "telephone_number": "918-400-7001",
            "fax_number": "539-202-5070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11511 E 31st St",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741461908",
            "country_code": "US",
            "telephone_number": "918-400-7002",
            "fax_number": "539-202-5130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1918 NE 23rd St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731113328",
            "country_code": "US",
            "telephone_number": "405-453-8000",
            "fax_number": "405-561-4984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "EVODIO",
        "middle_name": "HECTOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-31",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "3129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryah Estes
• Emily Estle, CRNA
• Dalia Estrada
• Demetria Yvonne Estrada
• Dilys Estrada
• Gilda Estrada
• Jessica Hope Estrada, PHARMD
• Ethan D Lindsey MD PC
• Robert Ethel, M.D., MBS
• James Scott Etheridge, APRN-CNP

• Physician Assistant in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.