Organization Active NPI

Calata Medical Group Inc

  • Adult Medicine Physician
  • Miami, FL
National Provider Identifier
1013626472
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
CALATA MEDICAL GROUP INC
Practice address
10890 NW 17TH St Unit 126
Miami, FL 33172-2068
Phone
(617) 959-9214
Fax
(786) 866-4726
NPI assigned
Nov 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Authorized official

Name
Tania Aidee Velez Calao, MDNPI 1942573316
Title
President
Phone
(617) 959-9214

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0505X Primary

Addresses

Primary practice location

10890 NW 17TH St Unit 126
Miami, FL 33172-2068

Mailing address

10890 NW 17TH St Unit 126
Miami, FL 33172-2068
Phone (617) 959-9214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230424002076 FL Part B Supplier - Clinic/Group Practice 3577928746 Receives reassigned benefits from 2 practitioners
Practice locations: Miami, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2285842Calata Medical Group Inc10890 NW 17TH St Suite 126, Miami, FL 33172Certificate of waiverJul 18, 2027

National Provider Directory

National Provider Directory

Locations

10890 NW 17th St
Unit 126
Miami, FL 33172
Phone (617) 959-9214

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668470400000",
    "number": "1013626472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10890 NW 17TH ST UNIT 126",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331722068",
            "telephone_number": "617-959-9214",
            "fax_number": "786-866-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10890 NW 17TH ST UNIT 126",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331722068",
            "telephone_number": "617-959-9214",
            "fax_number": "786-866-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALATA MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-15",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A",
        "authorized_official_last_name": "VELEZ CALAO",
        "authorized_official_first_name": "TANIA",
        "authorized_official_middle_name": "AIDEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-959-9214",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.