Individual provider Active NPI

Talia A Calabro, PA

  • Physician Assistant
  • Fort Lauderdale, FL
National Provider Identifier
1215330709
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9118242 Issued in FL
Practice address
1995 E Oakland Park Blvd Ste 310
Ft Lauderdale, FL 33306-1138
Phone
(954) 791-6146
NPI assigned
Sep 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 017838 NY
Physician Assistant 363A00000X 9118242 FL Primary

Addresses

Primary practice location

1995 E Oakland Park Blvd Ste 310
Ft Lauderdale, FL 33306-1138

Mailing address

PO Box 936535
Atlanta, GA 31193-6535
Phone (716) 844-5600

Other practice location 1

500 Sterling Dr
Orchard Park, NY 14127-1573
Phone (716) 677-2273 ext. 612

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
I20240515003991 FL Practitioner - Physician Assistant 9133340342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Practitioners, LLCGroup PAC ID 1658688304, 63 clinicians

Practice addresses (Care Compare)

1000 NE 56TH St
Fort Lauderdale, FL 33334-4149
Phone (954) 229-8635

1210 S Old Dixie Hwy
Jupiter, FL 33458-7205
Phone (561) 747-2234

2815 S Seacrest Blvd
Boynton Beach, FL 33435-7969
Phone (561) 735-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.58 of 100Reported as group
Quality
39.81
Promoting interoperability
88
Improvement activities
40
Cost
83.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9118242FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Physician, PC CurrentSince May 1, 2022 Accepting new patients

Locations

3085 Harlem Rd
Ste 200
Cheektowaga, NY 14225
Phone (716) 844-5000

3085 Harlem Rd
Ste 350
Cheektowaga, NY 14225
Phone (716) 844-5000

500 Sterling Dr
Orchard Park, NY 14127
Phone (716) 677-2273

Interoperability endpoints

  • Direct secure messaging: tcalabro54570@direct-guthrie.org
  • Direct secure messaging: tcalabro27675@jupitermedicalcenter.direct-ci.com

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": "1411948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1215330709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936535",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936535",
            "telephone_number": "716-844-5600",
            "fax_number": "716-844-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 E OAKLAND PARK BLVD STE 310",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061138",
            "telephone_number": "954-791-6146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Sterling Dr",
            "address_purpose": "LOCATION",
            "city": "Orchard Park",
            "state": "NY",
            "postal_code": "141271573",
            "country_code": "US",
            "telephone_number": "716-677-2273 x612",
            "fax_number": "716-677-2566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALABRO",
        "first_name": "TALIA",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-29",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017838",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9118242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.