Active NPI
Jose Calderon, M.D.
- Psychiatry Physician
- New Haven, CT
National Provider Identifier
1184367351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 78864
- Practice address
- Connecticut Mental Health Center
34 Park Street
New Haven, CT 06519 - Phone
- (203) 785-2095
- NPI assigned
- Apr 15, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | 78864 | CT | Primary |
Addresses
Primary practice location
Connecticut Mental Health Center
34 Park Street
New Haven, CT 06519
Mailing address
Connecticut Mental Health Center
34 Park Street
New Haven, CT 06519
Phone (203) 415-3686
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 78864 | CT | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720742400000",
"number": "1184367351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CONNECTICUT MENTAL HEALTH CENTER",
"address_2": "34 PARK STREET",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "06519",
"telephone_number": "203-415-3686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CONNECTICUT MENTAL HEALTH CENTER",
"address_2": "34 PARK STREET",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "06519",
"telephone_number": "203-785-2095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALDERON",
"first_name": "JOSE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-04-15",
"last_updated": "2024-07-12",
"certification_date": "2024-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "78864",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.