Active NPI
Kristen Grace Calderon, PA-C
- Physician Assistant
- Elkhorn, NE
National Provider Identifier
1124837851
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 3211
- Practice address
- 717 N 190TH PLZ Ste 1100
Elkhorn, NE 68022-3917 - Phone
- (402) 815-1700
- Fax
- (402) 815-1959
- NPI assigned
- Jan 7, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 3211 | NE | Primary |
Addresses
Primary practice location
717 N 190TH PLZ Ste 1100
Elkhorn, NE 68022-3917
Mailing address
PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Creighton University School of Medicine, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3105 N 93Rd St
Omaha, NE 68134-4717
Phone (866) 290-4325
717 N 190TH PLZ
Suite 1100
Elkhorn, NE 68022-3917
Phone (402) 815-1700
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3211 | NE | MD | Dental Hygienist |
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 and National Provider Directory roles.
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- Family Medicine Physician
- Omaha, NE
- NPI 1821049156
-
- Non-Surgical Family Planning Clinic/Center
- Iowa City, IA
- NPI 1144260027
NE
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780012800000",
"number": "1124837851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3755",
"city": "OMAHA",
"state": "NE",
"postal_code": "681030755",
"telephone_number": "402-354-2100",
"fax_number": "402-354-2155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "717 N 190TH PLZ STE 1100",
"city": "ELKHORN",
"state": "NE",
"postal_code": "680223917",
"telephone_number": "402-815-1700",
"fax_number": "402-815-1959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALDERON",
"first_name": "KRISTEN",
"middle_name": "GRACE",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-07",
"last_updated": "2026-05-29",
"certification_date": "2026-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NE",
"license": "3211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkhorn, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; 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.