Individual provider Active NPI

Kristina Caldararo, LCSW

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1144654393
Registry record updated Oct 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
085670-1 Issued in NY
Practice address
4419 3Rd Ave
Bronx, NY 10457-2562
Phone
(718) 364-7700
NPI assigned
Aug 23, 2013
Last updated
Oct 27, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 085670-1 NY Primary
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

4419 3Rd Ave
Bronx, NY 10457-2562

Mailing address

4419 3Rd Ave
Bronx, NY 10457-2562

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190628001638 NY Practitioner - Clinical Social Worker 8022342765 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urban Health Plan IncGroup PAC ID 3173517281, 158 clinicians

Practice addresses (Care Compare)

1065 Southern Blvd
Bronx, NY 10459-2417
Phone (718) 589-2440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085670-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Urban Health Plan, Inc. CurrentSince May 18, 2019 Accepting new patients
Urban Health Plan, Inc. CurrentSince May 18, 2019 Accepting new patients

Locations

1065 Southern Blvd
Bronx, NY 10459
Phone 71858924404222

1515 Southern Blvd
#H
Bronx, NY 10460
Phone (718) 589-1600

4419 3rd Ave
Bronx, NY 10457
Phone (718) 364-7700

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1377216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509062400000",
    "number": "1144654393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4419 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572562",
            "telephone_number": "718-364-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDARARO",
        "first_name": "KRISTINA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-23",
        "last_updated": "2017-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085670-1",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.