Rodegelio C Estrada, MD

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

44191 Issued in MA

Practice address

83 South St
Ste 4
Ware, MA 01082-1660

Phone

(413) 967-5588

Fax

(413) 967-3166

NPI assigned

Sep 29, 2005

Last updated

Jun 30, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1972590487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 SOUTH ST",
            "address_2": "STE 4",
            "city": "WARE",
            "state": "MA",
            "postal_code": "010821660",
            "telephone_number": "413-967-5588",
            "fax_number": "413-967-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 SOUTH ST",
            "address_2": "STE 4",
            "city": "WARE",
            "state": "MA",
            "postal_code": "010821660",
            "telephone_number": "413-967-5588",
            "fax_number": "413-967-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "RODEGELIO",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "MA",
            "license": "44191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0101079",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIEL",
            "identifier": "B05040",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eula Shianne Drummer
• Paul Drzyzga
• Autumn Dubois
• Brooke Taylor Dubois
• Kenneth Mitchell Duda, OD
• Carol Estridge
• Excaliber
• Christine Fabel, CPNP
• Denise Finn-Rizzo, NP
• Lynn Fitzgerald

• Adult Medicine Physician in Ware, MA
• Providers in Ware, MA by specialty
• Adult Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.