DR. NEIL MICHAEL S ESTRELLA M.D. NPI 1669401030

Internal Medicine in Clark, NJ

NPI 1669401030 Individual Male Years of Experience 22 Internal Medicine PECOS Enrolled Accepts Medicare Approved Payment

NPI Profile for DR. NEIL MICHAEL S ESTRELLA M.D.

Neil Michael Estrella is an internal medicine provider established in Clark, New Jersey and his medical specialization is internal medicine with more than 22 years of experience. The NPI number of Neil Michael Estrella is 1669401030 and was assigned on June 2006. The practitioner's primary taxonomy code is 207R00000X with license number 25MA07952100 (NJ). The provider is registered as an individual and his NPI record was last updated 14 years ago.

An internist like Dr. Neil Michael S Estrella M.d. is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Neil Michael Estrella is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Neil Michael Estrella is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Robert Wood Johnson University Hospital At Rahway and Trinitas Regional Medical Center.

The typical physician office visit costs for Medicare beneficiaries in this area are: $37.64 for a new patient copayment and $29.21 for an established patient copayment.

NPI

1669401030

Provider NameDR. NEIL MICHAEL S ESTRELLA M.D.
Provider Location Address999 RARITAN RD CLARK, NJ 07066
Provider Mailing Address999 RARITAN RD CLARK, NJ 07066
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2001
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date06-30-2006
Last Update Date01-28-2008


Primary Taxonomy

Taxonomy Code207R00000X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
License No.25MA07952100
License StateNJ
Taxonomy DescriptionA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Business Address

DR. NEIL MICHAEL S ESTRELLA M.D.
999 RARITAN RD
CLARK, NJ
ZIP 07066
Phone: (732) 381-3740
Fax: (732) 381-3733

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Mailing Address

DR. NEIL MICHAEL S ESTRELLA M.D.
999 RARITAN RD
CLARK, NJ
ZIP 07066
Phone: (732) 381-3740
Fax: (732) 381-3733



PECOS Enrollment and Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID8426052721
PECOS Enrollment IDI20060829000095
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 07066 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99204
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$66.45 $198.48 $150.56
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$16.61 $49.62 $37.64
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$21.27 $162.58 $116.86
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$5.31 $40.64 $29.21

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 527Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • 393Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)
  • 121Routine EKG using at least 12 leads including interpretation and report (HCPCS:93000)
  • 109Administration of influenza virus vaccine (HCPCS:G0008)
  • 107Hemoglobin A1C level (HCPCS:83036)
  • 92Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • 75Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple (HCPCS:G0180)
  • 23Administration of pneumococcal vaccine (HCPCS:G0009)
  • 15Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial im (HCPCS:G0179)

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Neil Michael Estrella is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT RAHWAY865 STONE ST
RAHWAY, NJ 7065
(732) 381-4200Acute Care Hospitals310024
TRINITAS REGIONAL MEDICAL CENTER225 WILLIAMSON STREET
ELIZABETH, NJ 7207
(908) 994-5000Acute Care Hospitals310027

NPI Validation Check Digit Calculation


The following table explains step by step the NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1669401030
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2612980206
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 1 + 2 + 9 + 8 + 0 + 2 + 0 + 6 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1669401030 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 8 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1487634846 JOSEPH EDWARD OCHS MA , LPC
Individual
Specialist999 RARITAN RD BOX 885
CLARK, NJ 07066
(732) 381-6118
1942263777DAVID E. WEXLER, M.D., F.A.C.G., L.L.C.
Organization
Internal Medicine (Gastroenterology)999 RARITAN RD
CLARK, NJ 07066
(732) 499-8000
1437265568MR. ROGER MAITLAND PHD PSYCHOLOGY
Individual
Psychologist999 RARITAN RD
CLARK, NJ 07066
(732) 381-6118
1992829980 JIHONG DING C.A.
Individual
Acupuncturist999 RARITAN RD
CLARK, NJ 07066
(732) 388-8828
1215143995MS. EDNA ABBY SILVERMAN LPC
Individual
Counselor (Professional)999 RARITAN RD CLARK PSYCHOLOGY CTR
CLARK, NJ 07066
(732) 381-6118
1508017534 TARA PRISCO PA
Individual
Physician Assistant (Medical)999 RARITAN RD
CLARK, NJ 07066
(732) 381-9418
1639495187NEW JERSEY DIGESTIVE DISEASE ASSOCIATES, PC
Organization
Internal Medicine (Gastroenterology)999 RARITAN RD
CLARK, NJ 07066
(732) 499-8000
1740306729DING ACUPUNCTURE AND HERB CENTER P.C.
Organization
Acupuncturist999 RARITAN RD
CLARK, NJ 07066
(732) 388-8828

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Dr. Neil Michael S Estrella M.d. is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.