Individual provider Active NPI

Juan Calisto, MD

  • Pediatric Surgery Physician
  • Miami, FL
National Provider Identifier
1245465863
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
132498 Issued in FL
Practice address
3200 SW 60TH CT Ste 201
Miami, FL 33155-4070
Phone
(305) 662-8220
Fax
(305) 665-2467
NPI assigned
May 27, 2009
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 27042 OK
Surgical Critical Care Physician 2086S0102X 132498 FL
Pediatric Surgery Physician 2086S0120X 132498 FL Primary

Addresses

Primary practice location

3200 SW 60TH CT Ste 201
Miami, FL 33155-4070

Mailing address

3200 SW 60TH CT
Suite #201
Miami, FL 33155-4000
Phone (305) 662-8320

Other practice location 1

920 Sl Young Blvd
WP 2140
Oklahoma City, OK 73104-5033
Phone (405) 271-6308

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
I20260604002434 FL Practitioner - General SurgeryPractitioner - Thoracic SurgeryPractitioner - Pediatric Medicine 4082185699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Pediatric Medicine, Thoracic Surgery
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Miami Associates in Pediatric Surgery PAGroup PAC ID 6103844303, 4 clinicians

Practice addresses (Care Compare)

3200 SW 60TH CT
Suite 201
Miami, FL 33155-4070
Phone (305) 662-8320

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27042OKMDSurgery Physician
132498FLMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Miami Associates in Pediatric Surgery PA PastSince Nov 21, 2019 Accepting new patients
Nicklaus Children's Pediatric Specialists, LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/9d02172d-d861-4f2f-87b5-3b1c5ad61f32/
  • Direct secure messaging: juan.luis.calisto.aguirre.1@240.direct.athenahealth.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.

NPI Registry JSON

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1245465863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 SW 60TH CT",
            "address_2": "SUITE #201",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331554000",
            "telephone_number": "305-662-8320",
            "fax_number": "305-665-2467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SW 60TH CT STE 201",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331554070",
            "telephone_number": "305-662-8220",
            "fax_number": "305-665-2467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Sl Young Blvd",
            "address_2": "WP 2140",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731045033",
            "country_code": "US",
            "telephone_number": "405-271-6308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALISTO",
        "first_name": "JUAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "27042",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "FL",
            "license": "132498",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "FL",
            "license": "132498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.