Dolores Calderon, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A73325 Issued in CA

Practice address

10305 Promenade Pkwy
Elk Grove, CA 95757-9400

Phone

(916) 544-6000

Fax

(916) 544-6480

NPI assigned

Jul 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Dolores Policicchio Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dpolicicchio135952@hpmg.direct-ci.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Family Medicine

  Medicare reassignment NPD
• Timberlake Family Practice a Medical Corporation

  • Family Medicine Physician
  • Elk Grove, CA
  • NPI 1962516591
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1841373800

  Family Medicine

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Hill Physicians Medical Group - PPO Program

  • Preferred Provider Organization
  • San Ramon, CA
  • NPI 1679011035
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1417989666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10305 PROMENADE PKWY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957579400",
            "telephone_number": "916-544-6000",
            "fax_number": "916-544-6480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10305 PROMENADE PKWY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957579400",
            "telephone_number": "916-544-6000",
            "fax_number": "916-544-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERON",
        "first_name": "DOLORES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A73325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10305 Promenade Pkwy",
            "city": "Elk Grove",
            "state": "CA",
            "country_code": "US",
            "postal_code": "957579400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DOLORES",
            "last_name": "POLICICCHIO",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jiamin Cai
• Jennifer Cajina Flores
• Cassandra Michelle Cala-Peryea, ASW, M.A.
• Lani Calagui
• Leo Calaustro
• Guadalupe Calderon
• Natalia Calderon
• Shachrista Caldwell
• California Correctional Health Care Services
• California Hospitalist Physicians Inc

• Family Medicine Physician in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.