Individual provider Active NPI

Calvin Frederick Paniagua II, PA-C

  • Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1326144577
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1021 Issued in NV
Practice address
5891 E Charleston Blvd
Suite 150
Las Vegas, NV 89142-1050
Phone
(725) 777-3120
Fax
(725) 777-3119
NPI assigned
Sep 15, 2006
Last updated
Apr 4, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 17465 CA
Physician Assistant 363A00000X 3024 AZ
Physician Assistant 363A00000X PA1021 NV Primary
Physician Assistant 363A00000X 0003911 CO
Physician Assistant 363A00000X 5601004343 MI

Addresses

Primary practice location

5891 E Charleston Blvd
Suite 150
Las Vegas, NV 89142-1050

Mailing address

PO Box 270662
Las Vegas, NV 89127-4662
Phone (702) 823-3813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20181003000410 MI Practitioner - Physician Assistant 2163451360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet Urgent Care of MichiganGroup PAC ID 6305188491, 129 clinicians

Practice addresses (Care Compare)

15606 Southfield Rd
Allen Park, MI 48101-2513
Phone (313) 771-5274

16525 Fort St
Southgate, MI 48195-1403
Phone (734) 250-9529

18700 Mack Ave
Grosse Pointe Farms, MI 48236-2923
Phone (313) 925-3486

18930 W Rd
Beaumont Urgent Care of Michigan
Woodhaven, MI 48183-3317
Phone (734) 671-4900

19760 Haggerty Rd
Beaumont Urgent Care of Michigan
Livonia, MI 48152-1080
Phone (734) 793-8769

2078 E Big Beaver Rd
Beaumont Urgent Care of Michigan
Troy, MI 48083-2301
Phone (248) 918-0744

23100 Michigan Ave
Dearborn, MI 48124-2033
Phone (313) 263-7584

27810 Grand River Ave
Farmington Hills, MI 48336-5916
Phone (248) 957-1989

29263 Orchard Lake Rd
Farmington Hills, MI 48334-2953
Phone (248) 488-5900

34435 Michigan Ave
Wayne, MI 48184-1763
Phone (734) 589-1524

42757 Woodward Ave
Beaumont Urgent Care by Wellstreet
Bloomfield Hills, MI 48304-5037
Phone (248) 940-4937

6549 N Canton Ctr Rd
Beaumont Urgent Care of Michigan
Canton, MI 48187-1653
Phone (734) 589-1969

9870 Telegraph Rd
Taylor, MI 48180-3399
Phone (313) 291-6600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.04 of 100Reported as group
Quality
67.93
Promoting interoperability
100
Improvement activities
40
Cost
52.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3024AZMDPhysician Assistant
0003911COMDPhysician Assistant
5601004343MIMDPhysician Assistant
PA1021NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Action Urgent Care Inc Past Accepting new patients
Wellstreet Urgent Care of Michigan PastSince Aug 6, 2023 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24970/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1326144577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270662",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891274662",
            "telephone_number": "702-823-3813",
            "fax_number": "725-777-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5891 E CHARLESTON BLVD",
            "address_2": "SUITE 150",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891421050",
            "telephone_number": "725-777-3120",
            "fax_number": "725-777-3119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANIAGUA",
        "first_name": "CALVIN",
        "middle_name": "FREDERICK",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "17465",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3024",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1021",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "0003911",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004343",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.