Medicare billing address
CMS Medicare provider billing file
500 University DrHershey, PA 17033
CMS public data · NPI 1134689938
Dr. James Estipona: Medicare prescribing and billing data
CMS public files list billing, prescribing, location, and participation fields for this NPI. Current plan networks, appointment availability, clinical outcomes, and patient-specific medical advice require separate verification.
CMS display name
James Estipona, DO
Specialty
Credential
DO
NPI
1134689938
Primary source state
PA
Data retrieval date
July 28, 2026
What related Medicare data is on this site?
Pennsylvania doctorsState Doctor hubFamily PracticeState-specialty hubHershey, PAPrimary city link if this route exists
Where these numbers come from, and what they cannot tell you
Public CMS records, 2024 reporting year. These are historical Medicare fields, not proof of current coverage, appointment availability, quality, or what someone will pay.
How should you read this Doctor page?
This page shows Medicare billing and Part D prescribing data for James Estipona, DO from CMS public files. It covers 2024 claims data: services billed, the beneficiary panel, and the most-prescribed Part D drugs. It does not show current coverage, appointment availability, or quality ratings.
A licensed agent, not a call center
Do your doctors and prescriptions fit before you enroll?
Peter Abilla, Licensed Medicare Insurance Sales Agent, NPN 22265186. Bring the doctors and prescriptions that matter to you, then check the details before you enroll.
What Medicare source indicators are listed for this NPI?
Medicare participating
Yes
Individual assignment
Yes
Group assignment
Yes
CMS opt-out records
0
Which practice locations appear in CMS files?
When CMS files list more than one address for the same NPI, each address stays tied to the CMS file that reported it.
Hershey, PA 17033
THE MILTON S HERSHEY MEDICAL CENTER PHYSICIANS GROUP
CMS Doctors & Clinicians file
143 Hospital DrState College, PA 16803
THE MILTON S HERSHEY MEDICAL CENTER PHYSICIANS GROUP
CMS Doctors & Clinicians file
32 Colonnade WayState College, PA 16803
What does the Medicare billing file show?
In the 2024 CMS provider billing file, this NPI had 546 Medicare beneficiaries and 3,583 total services. The average beneficiary age was 76, and the average HCC risk score was 0.9.
Total Medicare allowed amount
$220,704.01
Total Medicare payment amount
$169,843.29
Medicare beneficiaries
546
Total services
3,583
Which patient-panel condition fields does CMS report?
These percentages describe the Medicare beneficiary panel in the CMS utilization file. They are not a diagnosis for any individual patient and are not a quality score.
Hyperlipidemia
75%
CMS beneficiary-panel share
Hypertension
66%
CMS beneficiary-panel share
Diabetes
25%
CMS beneficiary-panel share
Ischemic heart disease
21%
CMS beneficiary-panel share
Atrial fibrillation
19%
CMS beneficiary-panel share
Chronic kidney disease
17%
CMS beneficiary-panel share
Where these service numbers come from, and what they cannot tell you
Amounts shown are average Medicare-approved amounts per billed unit in CMS records. What a person pays depends on current coverage and cannot be read from this table alone.
Which Medicare services appear most often?
| CMS service description | Services | Avg allowed |
|---|---|---|
| Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 560 | $126.06 |
| Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's | 452 | $16.19 |
| Injection, methylprednisolone acetate, 1 mg | 420 | $0.13 |
| Insertion of needle into vein for collection of blood sample | 338 | $8.65 |
| Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 325 | $128.59 |
| Annual depression screening, 5 to 15 minutes | 324 | $18.65 |
| Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 224 | $89.29 |
| Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | 213 | $177.75 |
| Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 140 | $0.99 |
| Advance care planning, first 30 minutes | 73 | $81.07 |
Where these Part D numbers come from, and what they cannot tell you
CMS data reports historical prescription drug events attributed to NPI 1134689938. Formularies, copays, prior authorization, and step therapy rules vary by current coverage.
Which drugs did James Estipona, DO prescribe most often under Medicare Part D?
| Rank | Drug | Generic name | Total claims | 30-day fills | Total drug cost |
|---|---|---|---|---|---|
| 1 | Atorvastatin Calcium | Atorvastatin Calcium | 592 | 1,768.4 | $5,464.63 |
| 2 | Levothyroxine Sodium | Levothyroxine Sodium | 502 | 1,493.4 | $4,230.92 |
| 3 | Amlodipine Besylate | Amlodipine Besylate | 411 | 1,228.9 | $2,329.12 |
| 4 | Lisinopril | Lisinopril | 399 | 1,192.5 | $2,809.18 |
| 5 | Losartan Potassium | Losartan Potassium | 314 | 932.3 | $2,896.20 |
| 6 | Gabapentin | Gabapentin | 275 | 671.5 | $5,015.75 |
| 7 | Omeprazole | Omeprazole | 235 | 684.6 | $4,779.15 |
| 8 | Metformin Hcl | Metformin Hcl | 222 | 640.8 | $1,443.00 |
| 9 | Tamsulosin Hcl | Tamsulosin Hcl | 220 | 654.4 | $3,125.83 |
| 10 | Rosuvastatin Calcium | Rosuvastatin Calcium | 211 | 628.8 | $2,669.67 |
CMS Part D records are historical aggregate claims data. They do not include current formulary status, pharmacy price, prior-authorization rules, network-directory status, or clinical-outcome data.
What background fields does CMS report?
Medical school
Lake Erie Col Of Osteo Med At Seton Hill Univ
Graduation year
2019
Group/practice field
The Milton S Hershey Medical Center Physicians Group
Telehealth reported
Not reported
What can this data not tell us?
- Billing data and prescribing data come from different CMS files. Neither one measures clinical outcomes, and neither one tells you whether this doctor is in a specific plan's network.
- Part D records do not report current medication use, plan coverage, price, pharmacy availability, or plan-directory status.
- Where CMS withholds a count for privacy, we show that note instead of a number. A withheld count is not zero.
- CMS billing data does not list Medicare Advantage plan-directory status for this doctor.
- CMS service and prescribing records are historical public-use aggregates; they do not report current appointment availability, clinical outcomes, or patient-specific medical advice.
- Part D provider-and-drug records do not include current formulary status, copay amount, pharmacy price, prior-authorization rules, or step-therapy rules.
What should you verify separately?
Verify plan-directory status, drug formulary rules, pharmacy pricing, appointment availability, and clinical questions against current plan documents and the relevant provider or care team.
Which CMS sources support this page?
The numbers above come from CMS public-use files for this NPI. Each link identifies the CMS release used and the retrieval date.
- Medicare Physician & Other Practitioners - by Provider · 1 records for this NPI · retrieved July 28, 2026
- Medicare Physician & Other Practitioners - by Provider and Service · 23 records for this NPI · retrieved July 28, 2026
- Doctors and Clinicians National Downloadable File · 2 records for this NPI · retrieved July 28, 2026
- Opt-Out Affidavits · 0 records for this NPI · retrieved July 28, 2026
- Medicare Part D Prescribers - by Provider and Drug · 126 records for this NPI · retrieved July 28, 2026
What caveats apply to this page?
- CMS billing and utilization files do not list Medicare Advantage plan networks, appointment availability, or clinical outcomes.
- Part D provider-and-drug files are historical aggregate claims data; they do not report current medication lists, plan coverage, pharmacy price, or prior-authorization rules.
- Where CMS withholds a count for privacy, we show that note instead of a number. A withheld count is not zero.