Individual provider Active NPI

Paul G. Calabrese, DDSMS

  • Endodontics
  • Orchard Park, NY
National Provider Identifier
1063597433
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
044775 Issued in NY
Practice address
6225 W Quaker St
Orchard Park, NY 14127-2641
Phone
(716) 667-2030
Fax
(716) 667-2034
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 044775 NY Primary

Addresses

Primary practice location

6225 W Quaker St
Orchard Park, NY 14127-2641

Mailing address

6225 W Quaker St
Orchard Park, NY 14127-2641
Phone (716) 667-2030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Feb 4, 2016 through Feb 4, 2028

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160603001074 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6800186826

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063597433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6225 W QUAKER ST",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272641",
            "telephone_number": "716-667-2030",
            "fax_number": "716-667-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6225 W QUAKER ST",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272641",
            "telephone_number": "716-667-2030",
            "fax_number": "716-667-2034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALABRESE",
        "first_name": "PAUL",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "DDSMS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "044775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.