Individual provider Active NPI

Lennie Calderon, APRN

  • Gerontology Nurse Practitioner
  • Celebration, FL
National Provider Identifier
1124535505
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN9216974 Issued in FL
Practice address
400 Celebration PL Ste A270
Celebration, FL 34747-4970
Phone
(407) 303-4078
Fax
(407) 303-4083
NPI assigned
Jan 6, 2018
Last updated
Jan 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN9216974 FL Primary

Addresses

Primary practice location

400 Celebration PL Ste A270
Celebration, FL 34747-4970

Mailing address

400 Celebration PL Ste A270
Celebration, FL 34747-4970
Phone (407) 303-4078

Other practice location 1

1300 W Oak St
Kissimmee, FL 34741-4024
Phone (407) 944-5240

Other practice location 2

1300 W Oak St
Kissimmee, FL 34741-4024
Phone (407) 944-5240

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20180706000726 FL Practitioner - Nurse Practitioner 6002162948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

400 Celebration PL
Suite A270
Celebration, FL 34747-4970
Phone (407) 303-4078

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN9216974FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Apr 22, 2018 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Apr 22, 2018 Accepting new patients

Locations

1300 W Oak St
Kissimmee, FL 34741
Phone (407) 944-5201

400 Celebration Pl
Ste A270
Kissimmee, FL 34747
Phone (407) 303-4078

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1515196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1124535505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CELEBRATION PL STE A270",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347474970",
            "telephone_number": "407-303-4078",
            "fax_number": "407-303-4083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CELEBRATION PL STE A270",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347474970",
            "telephone_number": "407-303-4078",
            "fax_number": "407-303-4083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 W Oak St",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347414024",
            "country_code": "US",
            "telephone_number": "407-944-5240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 W Oak St",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347414024",
            "country_code": "US",
            "telephone_number": "407-944-5240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALDERON",
        "first_name": "LENNIE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-06",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN9216974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Celebration, FL

Sources for this page

Verify at the official NPI Registry.