Individual provider Active NPI

Alejandro Callejas, MD

  • Surgery Physician
  • Port Charlotte, FL
National Provider Identifier
1275526097
Registry record updated Mar 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME0043036 Issued in FL
Practice address
2525 Harbor Blvd
203
Port Charlotte, FL 33952-5317
Phone
(941) 627-9119
Fax
(941) 627-3011
NPI assigned
Aug 26, 2005
Last updated
Mar 12, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME0043036 FL Primary

Addresses

Primary practice location

2525 Harbor Blvd
203
Port Charlotte, FL 33952-5317

Mailing address

2525 Harbor Blvd
203
Port Charlotte, FL 33952-5317
Phone (941) 627-9119

Other identifiers 2

IdentifierTypeStateIssuer
08126OtherFLBCBS
068716200MedicaidFL

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0043036FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Muhammed Y Memon MD PA Past Accepting new patients
Alejandro Callejas MD Surgery PastSince Jan 1, 1990 Accepting new patients

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": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236816000000",
    "number": "1275526097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 HARBOR BLVD",
            "address_2": "203",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525317",
            "telephone_number": "941-627-9119",
            "fax_number": "941-627-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 HARBOR BLVD",
            "address_2": "203",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525317",
            "telephone_number": "941-627-9119",
            "fax_number": "941-627-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLEJAS",
        "first_name": "ALEJANDRO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2009-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME0043036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "08126",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "068716200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.