Individual provider Active NPI

Emilio Claudio Calabrese, MD

  • Surgery Physician
  • Fort Walton Beach, FL
National Provider Identifier
1063852192
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
CDR.0000125 Issued in CO
Practice address
2010 Lewis Turner Blvd
Fort Walton Beach, FL 32547
Phone
(850) 460-0052
Fax
(844) 341-2523
NPI assigned
Jul 3, 2013
Last updated
Jul 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME116123 FL
Surgery Physician 208600000X CDR.0000125 CO Primary

Addresses

Primary practice location

2010 Lewis Turner Blvd
Fort Walton Beach, FL 32547

Mailing address

4516 E Highway 20
Suite 226
Niceville, FL 32578-9755
Phone (305) 934-9988

Other practice location 1

2222 N Nevada Ave Ste 5010
Colorado Springs, CO 80907-6865
Phone (719) 776-6700

Other identifiers 1

IdentifierTypeStateIssuer
016028200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: ecalabre@yourcarecommunity.org
  • FHIR API: https://api.platform.athenahealth.com/12245/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1063852192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4516 E HIGHWAY 20",
            "address_2": "SUITE 226",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325789755",
            "telephone_number": "305-934-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 LEWIS TURNER BLVD",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "32547",
            "telephone_number": "850-460-0052",
            "fax_number": "844-341-2523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 N Nevada Ave Ste 5010",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809076865",
            "country_code": "US",
            "telephone_number": "719-776-6700",
            "fax_number": "719-776-6780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALABRESE",
        "first_name": "EMILIO",
        "middle_name": "CLAUDIO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-03",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME116123",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "CDR.0000125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016028200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.