Individual provider Active NPI

Derreck Caldez, DPT

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1326777624
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
32371 Issued in AZ
Practice address
16611 S 40TH St Ste 130
Phoenix, AZ 85048-0564
Phone
(480) 706-1199
Fax
(480) 706-3999
NPI assigned
Jun 10, 2022
Last updated
Jun 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 32371 AZ Primary

Addresses

Primary practice location

16611 S 40TH St Ste 130
Phoenix, AZ 85048-0564

Mailing address

14287 N 87TH St Ste 220
Scottsdale, AZ 85260-3698
Phone (480) 937-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220727003006 AZ Practitioner - Physical Therapist in Private Practice 8224410923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Creighton University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

16611 S 40TH St
Suite 130
Phoenix, AZ 85048-0564
Phone (480) 706-1199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spooner Physical Therapy & Hand Rehab, PC CurrentSince Jun 6, 2022 Accepting new patients
Spooner Physical Therapy and Hand Rehab, PC Physical Therapist CurrentSince Jun 6, 2022 Accepting new patients
Spooner Physical Therapy & Hand Rehab, PC Current Accepting new patients
Spooner Physical Therapy & Hand Rehab, PC Past Accepting new patients

Locations

16611 S 40th St
Ste 130
Phoenix, AZ 85048
Phone (480) 706-1199

14287 N 87th St
Ste 220
Scottsdale, AZ 85260

9097 E Desert Cove Ave
Ste 110
Scottsdale, AZ 85260
Phone (480) 860-4298

Organizations & group practices 4

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": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1326777624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14287 N 87TH ST STE 220",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603698",
            "telephone_number": "480-937-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16611 S 40TH ST STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480564",
            "telephone_number": "480-706-1199",
            "fax_number": "480-706-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDEZ",
        "first_name": "DERRECK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "32371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.