Dexter Mata Caldona

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

26NJ00636200 Issued in NJ

Practice address

39 Aycrigg Ave
Passaic, NJ 07055-5664

Phone

(973) 981-0476

NPI assigned

Apr 25, 2018

Last updated

Apr 25, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kane Wound Care LLCGroup PAC ID 2567591274, 53 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

51.39 of 100Reported as group

Quality

64.84

Promoting interoperability

0

Improvement activities

0

Cost

73.11

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kane Wound Care LLC

  dba d/b/a Princeton Wound Care Center

  • Internal Medicine Physician
  • Princeton, NJ
  • NPI 1275869802
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524614400000",
    "number": "1114415155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 AYCRIGG AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070555664",
            "telephone_number": "973-981-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 AYCRIGG AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070555664",
            "telephone_number": "973-981-0476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDONA",
        "first_name": "DEXTER",
        "middle_name": "MATA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-25",
        "last_updated": "2018-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00636200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander L Budhi Jr., PT/DPT
• Stacey Allyson Butler, LCSW
• Caitlin Byrne
• Christian Cabrera, LCSW
• Rosa Calderon, M.D.
• Antonio Camilo, MD
• Nicauris Camilo
• Capital Anesthesia Solutions of New Jersey, LLC
• Capitol Chiropractic and Rehab LLC
• Cardinal Health 132, LLC (North Hudson Pharmacy at Passaic)

• Nurse Practitioner in Passaic, NJ
• Providers in Passaic, NJ by specialty
• Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.