Provider Demographics
NPI:1285602433
Name:GUMPERTZ, ESTI G (MD)
Entity type:Individual
Prefix:DR
First Name:ESTI
Middle Name:G
Last Name:GUMPERTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6801 MAYFIELD RD
Mailing Address - Street 2:SUITE 244
Mailing Address - City:MAYFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2270
Mailing Address - Country:US
Mailing Address - Phone:440-646-1600
Mailing Address - Fax:440-646-1505
Practice Address - Street 1:6801 MAYFIELD RD
Practice Address - Street 2:SUITE 244
Practice Address - City:MAYFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44124-2270
Practice Address - Country:US
Practice Address - Phone:440-646-1600
Practice Address - Fax:440-646-1505
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-12
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35052867207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000133524OtherBLUE CROSS / BLUE SHIELD
OH0631034Medicaid
341537793OtherPROFESSIONAL CLAIMS MANAGEMENT
341537793OtherSECURE HORIZONS
341537793OtherTRICARE
3415377930001OtherEXPACARE
3415377930001OtherUNITED AMERICAN INSURANCE
OH0631034OtherPEOPLE'S HEALTH PLAN
102510OtherKAISER PERMANENTE
341537793OtherAETNA
3415377930001OtherGOLDEN RULE
3415377930001OtherPRINCIPAL LIFE INSURANCE
R52867OtherSUMACARE
341537793OtherMAIL HANDLERS
3415377930001OtherEMERALD HEALTH NETWORK
3415377930001OtherNIPPON LIFE INSURANCE
OH07000311OtherRAILROAD MEDICARE
3415377930001OtherFIRST HEALTH
3415377930001OtherHEALTHLINK
3415377930001OtherOHIO CONFERENCE OF PLASTERERS
3415377930001OtherOHIO HEALTH CHOICE
OH34153779300OtherCAREWORKS
3415377930001OtherFLORIDA HEALTH CARE PLANS
72503454006OtherMEDICAL MUTUAL OF OHIO
3415377930001OtherCHRISTIAN BROTHERS
3415377930001OtherRETIREE MEDICAL INSURANCE
3415377930001OtherUNICARE
3415377930001OtherUNITED HEALTHCARE
341537793OtherHUMANA
341537793OtherNALC
34153779300OtherMEDICAL ADMINISTRATORS
3415377930001OtherCOMMUNITY INSURANCE
3415377930001OtherGREAT WEST
3415377930001OtherSTAR ADMINISTRATION SERVICES
OH351358OtherWELLCARE
R52867OtherAPEX
OH34153779300OtherBUREAU OF WORKERS COMPENSATION
3415377930001OtherCIGNA
3415377930001OtherTPA
OH341537793026OtherCARESOURCE
736416OtherBUCKEYE
OH341537793026OtherCARESOURCE
R52867OtherSUMACARE