Individual provider Active NPI

Esther R Servillas, MD

  • Internal Medicine Physician
  • Saint Joseph, MI
National Provider Identifier
1922418425
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301503819 Issued in MI
Practice address
3950 Hollywood Rd Ste 270
Saint Joseph, MI 49085-9158
Phone
(269) 983-0500
Fax
(269) 429-2240
NPI assigned
May 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036143974 IL
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 036143974 IL
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 4301503819 MI Primary

Addresses

Primary practice location

3950 Hollywood Rd Ste 270
Saint Joseph, MI 49085-9158

Mailing address

3950 Hollywood Rd Ste 270
Saint Joseph, MI 49085-9158
Phone (269) 983-0500

Other names 1

  • Esther Ramos Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL EPIC Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20210309001982 MI Practitioner - Family Practice 6800144551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

3950 Hollywood Rd
Suite 270
Saint Joseph, MI 49085-9158
Phone (269) 983-0500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036143974ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Medical Practices Internal Medicine CurrentSince Mar 19, 2021 Accepting new patients
Lakeland Medical Practices Internal Medicine CurrentSince Mar 19, 2021 Accepting new patients

Locations

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

3950 Hollywood Rd
Ste 270
Saint Joseph, MI 49085
Phone (269) 982-7840

4368 Cleveland Ave
Stevensville, MI 49127
Phone (269) 429-0710

Interoperability endpoints

  • Direct secure messaging: eservillas1271890@epic00.corewelldirect.org

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1399334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1922418425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 HOLLYWOOD RD STE 270",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859158",
            "telephone_number": "269-983-0500",
            "fax_number": "269-429-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 HOLLYWOOD RD STE 270",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859158",
            "telephone_number": "269-983-0500",
            "fax_number": "269-429-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERVILLAS",
        "first_name": "ESTHER",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-06",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036143974",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036143974",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301503819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EPIC",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3950 Hollywood Rd Ste 270",
            "city": "Saint Joseph",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490859158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ESTHER",
            "last_name": "RAMOS",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.