Individual provider Active NPI

Jeremy Estrada

  • Emergency Medicine Physician
  • Pleasanton, CA
National Provider Identifier
1841685856
Registry record updated Mar 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A155327 Issued in CA
Practice address
5555 W Las Positas Blvd
Pleasanton, CA 94588-4000
Phone
(925) 416-6585
NPI assigned
Apr 6, 2015
Last updated
Mar 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A155327 CA Primary

Addresses

Primary practice location

5555 W Las Positas Blvd
Pleasanton, CA 94588-4000

Mailing address

5555 W Las Positas Blvd
Pleasanton, CA 94588-4000
Phone (925) 416-6585

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20180918003047 CA Practitioner - Emergency Medicine 8628365889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Eastern Virginia Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pleasanton Emergency Medical GroupGroup PAC ID 0143118927, 38 clinicians

Practice addresses (Care Compare)

5555 W Las Positas Blvd
Pleasanton, CA 94588-4000
Phone (925) 416-3418

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.7 of 100Reported as group
Quality
57.11
Promoting interoperability
100
Improvement activities
40
Cost
73.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A155327CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pleasanton Emergency Medical Group Emergency Medicine CurrentSince Jul 9, 2018 Accepting new patients

Locations

1111 E Stanley Blvd
Livermore, CA 94550
Phone (925) 373-4018

5555 W Las Positas Blvd
Pleasanton, CA 94588
Phone (925) 416-3418

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1841685856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 W LAS POSITAS BLVD",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945884000",
            "telephone_number": "925-416-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 W LAS POSITAS BLVD",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945884000",
            "telephone_number": "925-416-6585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "JEREMY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-06",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A155327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.