Individual provider Active NPI

John Emil Caliendo, MD

  • Psychiatry Physician
  • Daytona Beach, FL
National Provider Identifier
1215097688
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME22268 Issued in FL
Practice address
350 N Clyde Morris Blvd
Daytona Beach, FL 32114-2733
Phone
(386) 676-7175
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME22268 FL Primary

Addresses

Primary practice location

350 N Clyde Morris Blvd
Daytona Beach, FL 32114-2733

Mailing address

350 N Clyde Morris Blvd
Daytona Beach, FL 32114-2733
Phone (386) 676-7175

Other identifiers 1

IdentifierTypeStateIssuer
259764100MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071011000073 FL Practitioner - Psychiatry 8921064239 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
R Franklin University of Med & Sci/Chicago Medical School, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Health Care Plan IncGroup PAC ID 9436201233, 97 clinicians

Practice addresses (Care Compare)

350 N Clyde Morris Blvd
Daytona Beach, FL 32114-2733
Phone (386) 238-3200

740 Dunlawton Ave
Suite 200
Port Orange, FL 32127-4240
Phone (386) 763-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME22268FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Health Care Plan, Inc CurrentSince Jul 29, 2019 Accepting new patients
Halifax Healthcare Systems Inc CurrentSince Jun 1, 2007 Accepting new patients
Florida Health Care Plan, Inc CurrentSince Jul 29, 2019 Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

350 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 238-3200

841 Jimmy Ann Dr
Daytona Beach, FL 32117
Phone (386) 274-5333

Use Ci1660
Orlando, FL 32886

740 Dunlawton Ave
Ste 200
Port Orange, FL 32127
Phone (386) 763-1000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1215097688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142733",
            "telephone_number": "386-676-7175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142733",
            "telephone_number": "386-676-7175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALIENDO",
        "first_name": "JOHN",
        "middle_name": "EMIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME22268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259764100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.