Individual provider Active NPI

Joel Rivera Estabillo, NP

  • Acute Care Nurse Practitioner
  • New York, NY
National Provider Identifier
1710135173
Registry record updated Aug 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
430365 Issued in NY
Practice address
1190 5TH Ave # 1028
New York, NY 10029-6503
Phone
(212) 659-6800
NPI assigned
Aug 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 430365 NY Primary

Addresses

Primary practice location

1190 5TH Ave # 1028
New York, NY 10029-6503

Mailing address

95 New York Ave
Bergenfield, NJ 07621-1330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20140128000339 NY Practitioner - Nurse Practitioner 0244381564 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 25, 2013 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 25, 2013 Accepting new patients
NP Associates PA PastSince Dec 27, 2007 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

1190 5th Ave
#1028
New York, NY 10029
Phone (212) 659-6864

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

1190 5th Ave
Ste GP2W
New York, NY 10029

1190 5th Ave
#2W
New York, NY 10029
Phone (212) 241-5646

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219881600000",
    "number": "1710135173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 NEW YORK AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076211330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 5TH AVE # 1028",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296503",
            "telephone_number": "212-659-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTABILLO",
        "first_name": "JOEL",
        "middle_name": "RIVERA",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-28",
        "last_updated": "2008-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "430365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.