Juan Pablo Estrada

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

65696 Issued in TN

Practice address

1020 McArthur St
Manchester, TN 37355-2453

Phone

(931) 954-1400

Fax

(931) 954-1550

NPI assigned

Apr 27, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, TX2 enrollments

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 2

Specialty

Dermatology

Education

Columbia University College of Physicians and Surgeons, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

87.25 of 100Reported as group

Promoting interoperability

85

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

89.8 of 100Reported as group

Promoting interoperability

88

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Oliver Street 5.01(a) Inc.

  dba U.S. Dermatology Partners

  • Dermatology Physician
  • Dallas, TX
  • NPI 1457695413
  Medicare reassignment Care Compare group NPD
• Cumberland Skin Surgery and Dermatology

  • Medical Specialty Clinic/Center
  • Lebanon, TN
  • NPI 1922138247
  Medicare reassignment NPD
• Pinnacle Dermatology, SC

  • Dermatology Physician
  • Joliet, IL
  • NPI 1861930984

  TN

  Medicare reassignment NPD
• Advanced Sleep Consultants of Middle TN, Inc

  • Medical Specialty Clinic/Center
  • Lebanon, TN
  • NPI 1912048307
  NPD (past)

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1871028878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5141 VIRGINIA WAY STE 350",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272319",
            "telephone_number": "630-519-6543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 MCARTHUR ST",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373552453",
            "telephone_number": "931-954-1400",
            "fax_number": "931-954-1550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "677 Church St NE",
            "address_2": "Wellstar Kennestone Regional Medical Center GME Office",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300601101",
            "country_code": "US",
            "telephone_number": "770-793-7742",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1725 Medical Center Pkwy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "371292250",
            "country_code": "US",
            "telephone_number": "615-893-4100",
            "fax_number": "615-893-2166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "JUAN",
        "middle_name": "PABLO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-27",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "65696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan Patrick Dyer, PA-C
• Efc-MHC, LLC
• Kristen Lovelady Elam, FNP
• Elite Quality Care, Inc (McArthur Manor Assisted Living)
• Patricia Beth Elliott, NP-C
• Extended Family Care LLC
• Extended Family Care LLC
• Nathan Eylander
• F&B Enterprises, LLC (Manchester Pain Center)
• Aleene Marie Falk

• Dermatology Physician in Manchester, TN
• Providers in Manchester, TN by specialty
• Dermatology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; 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.
• 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.

Verify at the official NPI Registry.