Active NPI
Esteban Henriquez
- Certified Registered Nurse Anesthetist
- Hartford, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 15858
- Practice address
- 1032 E Sumner St
Hartford, WI 53027-1608 - Phone
- (262) 673-2300
- Fax
- (262) 670-7620
- NPI assigned
- Aug 26, 2022
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 15858 | WI | Primary |
Addresses
Primary practice location
1032 E Sumner St
Hartford, WI 53027-1608
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (803) 326-2250
Other practice location 1
2031 N 49th St
Milwaukee, WI 53208-1737
Phone (619) 841-8785
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100292894 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | ehenriquez171539@aurora.direct-ci.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241023001336 | WI | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 2466985916 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aurora Medical Group, Inc.
Practice addresses (Care Compare)
1032 E Sumner St
Hartford, WI 53027-1608
Phone (262) 673-2300
Hospital & facility affiliations
- Aurora Medical Ctr Washington County
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15858 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
1032 E Sumner St
Hartford, WI 53027
Phone (262) 670-4300
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
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 and National Provider Directory roles.
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
Nurse Anesthetist, Certified Registered, WI
-
- Durable Medical Equipment & Medical Supplies
- Oshkosh, WI
- NPI 1326858044
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Milwaukee, WI
- NPI 1659599157
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hartford, WI
- NPI 1760420103
Hospital
-
- Clinic/Center
- Hartford, WI
- NPI 1306056056
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730764800000",
"number": "1760101299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735044",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735044",
"telephone_number": "803-326-2250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1032 E SUMNER ST",
"city": "HARTFORD",
"state": "WI",
"postal_code": "530271608",
"telephone_number": "262-673-2300",
"fax_number": "262-670-7620"
}
],
"practiceLocations": [
{
"address_1": "2031 N 49th St",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532081737",
"country_code": "US",
"telephone_number": "619-841-8785",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HENRIQUEZ",
"first_name": "ESTEBAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-26",
"last_updated": "2024-11-05",
"certification_date": "2024-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WI",
"license": "15858",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100292894",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "1032 E Sumner St",
"city": "Hartford",
"state": "WI",
"country_code": "US",
"postal_code": "530271608",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ehenriquez171539@aurora.direct-ci.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1032 E Sumner St",
"city": "Hartford",
"state": "WI",
"country_code": "US",
"postal_code": "530271608",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Hartford, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.