Individual provider Active NPI

Ricardo Calderon, MSN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1447702915
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP132438 Issued in TX
Practice address
1636 Lockhill Selma Rd
San Antonio, TX 78213-1929
Phone
(210) 541-8455
NPI assigned
Oct 31, 2016
Last updated
Mar 8, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP132438 TX Primary

Addresses

Primary practice location

1636 Lockhill Selma Rd
San Antonio, TX 78213-1929

Mailing address

1636 Lockhill Selma Rd
San Antonio, TX 78213-1929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170127000581 TX Practitioner - Nurse Practitioner 7315229309 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP132438TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heart of Texas Region MHMR Center CurrentSince Jul 1, 2018 Accepting new patients
Alpha Mental Health and Wellness, PLLC Psychiatric/Mental Health Past Accepting new patients
Cantera Psychiatry, PLLC PastSince Dec 14, 2016 Accepting new patients
Cognitive Endeavors, LLC Psychiatric/Mental Health PastSince May 26, 2020 Accepting new patients

Locations

110 S 12th St
Waco, TX 76701
Phone (254) 297-7124

Organizations & group practices 5

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": "1477872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1447702915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 LOCKHILL SELMA RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1636 LOCKHILL SELMA RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131929",
            "telephone_number": "210-541-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERON",
        "first_name": "RICARDO",
        "name_prefix": "Mr.",
        "credential": "MSN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-31",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP132438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.