Individual provider Active NPI

Cynthia Calderon

  • Family Nurse Practitioner
  • Twin Falls, ID
National Provider Identifier
1255160347
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8761378 Issued in ID
Practice address
857 Polk St
Twin Falls, ID 83301-4095
Phone
(208) 731-9404
NPI assigned
Jul 29, 2024
Last updated
Jan 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 60777 ID
Family Nurse Practitioner 363LF0000X 8761378 ID Primary

Addresses

Primary practice location

857 Polk St
Twin Falls, ID 83301-4095

Mailing address

754 19TH Ave E
Jerome, ID 83338-1521
Phone (208) 948-9333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20250519003587 ID Practitioner - Nurse Practitioner 6507384971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Walking E Family Practice PLLCGroup PAC ID 0244778777, 4 clinicians

Practice addresses (Care Compare)

857 Polk St
Twin Falls, ID 83301-4095
Phone (208) 731-9404

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
60777IDMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Walking E Family Practice PLLC Family CurrentSince Mar 9, 2025 Accepting new patients

Locations

857 Polk St
Twin Falls, ID 83301
Phone (208) 731-9404

Organizations & group practices 1

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 1

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": "1722211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1255160347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "754 19TH AVE E",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833381521",
            "telephone_number": "208-948-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "857 POLK ST",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014095",
            "telephone_number": "208-731-9404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERON",
        "first_name": "CYNTHIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-29",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ID",
            "license": "60777",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "8761378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.