Individual provider Active NPI

Antionette Renee Estis

  • Advanced Practice Midwife
  • Saint Paul, MN
National Provider Identifier
1831745025
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
407 Issued in MN
Practice address
153 Cesar Chavez St
Saint Paul, MN 55107-2226
Phone
(651) 602-7500
NPI assigned
Aug 13, 2019
Last updated
Jan 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 407 MN Primary

Addresses

Primary practice location

153 Cesar Chavez St
Saint Paul, MN 55107-2226

Mailing address

380 E Lafayette Frontage Rd Ste 200
Saint Paul, MN 55107-1216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200311002798 MN Practitioner - Certified Nurse Midwife (CNM) 5597193219 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

347 Smith Ave N
Suite 203
St Paul, MN 55102-2388
Phone (651) 241-7733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
West Side Community Health Services, Inc. CurrentSince Jan 28, 2020 Accepting new patients
West Side Community Health Services, Inc. CurrentSince Jan 28, 2020 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Aug 13, 2023 Accepting new patients
Allina Health System CurrentSince Jan 1, 2023 Accepting new patients
Allina Health System Current Accepting new patients
West Side Community Health Services, Inc. Current Accepting new patients
Allina Health System CurrentSince Jan 1, 2023 Accepting new patients
NPI 1083910871 Past Accepting new patients
Planned Parenthood Minnesota, North Dakota, South Dakota Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

347 Smith Ave N
Ste 203
Saint Paul, MN 55102
Phone (651) 241-7733

895 7th St E
Saint Paul, MN 55106
Phone (651) 793-2250

4194 Lexington Ave N
Shoreview, MN 55126
Phone (651) 483-5461

153 Cesar Chavez St
West Saint Paul, MN 55107
Phone (651) 222-1816

Interoperability endpoints

  • Direct secure messaging: testis615174@excellian.direct.allina.com

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1831745025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 E LAFAYETTE FRONTAGE RD STE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551071216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 CESAR CHAVEZ ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551072226",
            "telephone_number": "651-602-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTIS",
        "first_name": "ANTIONETTE",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-13",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": "407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.