Grace Esan, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01056843 Issued in IN

Practice address

2522 Waterbridge Way
Evansville, IN 47710-3200

Phone

(812) 422-6886

Fax

(812) 428-5508

NPI assigned

Sep 15, 2005

Last updated

Jun 20, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: grace.esan.1@7598.direct.athenahealth.com

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.

• St Mary's Medical Group, LLC

  dba Ascension Medical Group St. Vincent Evansville

  • Nephrology Physician
  • Evansville, IN
  • NPI 1619307873
  NPD (past)
• St. Mary's Health, Inc

  dba Ascension St. Vincent Evansville

  • Internal Medicine Physician
  • Evansville, IN
  • NPI 1497706287

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1811982895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2522 WATERBRIDGE WAY",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477103200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2522 WATERBRIDGE WAY",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477103200",
            "telephone_number": "812-422-6886",
            "fax_number": "812-428-5508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESAN",
        "first_name": "GRACE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-15",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01056843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200405340",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "grace.esan.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Mary's Medical Group, LLC",
            "address_1": "2522 Waterbridge Way",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477103200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly Ermi, LCSW
• Ashton Elizabeth Erny, OT
• Sarah Erwin-Waterman, RN, CEN, SANE
• Kate E Erwin, NP
• Mary K Erwin
• Eva Esarey, MT-BC
• Mary Elizabeth Esche, DPT
• Esmeralda Espinoza Martinez
• Erik Estep, LSW
• Harold Seward Esty IV, MSW, LCSW

• Pediatrics Physician in Evansville, IN
• Providers in Evansville, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.