Organization Active NPI

Victor a Estrada MD CHTD

  • Allergy & Immunology Physician
  • Las Vegas, NV
National Provider Identifier
1801200480
Registry record updated Oct 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
VICTOR A ESTRADA MD CHTD
Practice address
4445 S Eastern Ave
Suite a
Las Vegas, NV 89119-7851
Phone
(702) 735-1556
Fax
(702) 737-7495
NPI assigned
Jun 11, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2017

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

Authorized official

Name
Robyn Wolf
Title
Credentialing Specialist
Phone
(512) 732-2774

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X Primary

Addresses

Primary practice location

4445 S Eastern Ave
Suite a
Las Vegas, NV 89119-7851

Mailing address

PO Box 202110
Austin, TX 78720-2110
Phone (512) 732-2774

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150716002404 NV Part B Supplier - Clinic/Group Practice 7517270705 Receives reassigned benefits from 4 practitioners
Practice locations: Henderson, NV

National Provider Directory

National Provider Directory

Locations

4445 S Eastern Ave
Ste A
Las Vegas, NV 89119
Phone (702) 735-1156

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508284800000",
    "number": "1801200480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 202110",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787202110",
            "telephone_number": "512-732-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 S EASTERN AVE",
            "address_2": "SUITE A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891197851",
            "telephone_number": "702-735-1556",
            "fax_number": "702-737-7495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTOR A ESTRADA MD CHTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-11",
        "last_updated": "2017-10-18",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "512-732-2774"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.