Myra N Caballero, D.D.S.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

462 Grider Street Erie County Medical Center,
Suite 150
Buffalo, NY 14215

Phone

(716) 898-1686

Fax

(716) 845-6699

NPI assigned

May 20, 2019

Reactivated

Jan 27, 2020

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

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1447816038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 GRIDER STREET ERIE COUNTY MEDICAL CENTER,",
            "address_2": "SUITE 150",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14215",
            "telephone_number": "716-898-1686",
            "fax_number": "716-845-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 GRIDER STREET ERIE COUNTY MEDICAL CENTER,",
            "address_2": "SUITE 150",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14215",
            "telephone_number": "716-898-1686",
            "fax_number": "716-845-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABALLERO",
        "first_name": "MYRA",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-20",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "deactivation_date": "2020-01-13",
        "reactivation_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stanley Y Byun, MD
• Chelsea Bzduch, FNP
• Lindsey Bzibziak
• C James Chen PC
• C. Ramgopal M.D. P.C.
• Fransheska Caballeros, LMSW
• Robert Cabbagestalk
• Melanie Cacciotti
• Kelsey Cadwallader, PA-C
• Dorothy Caffrey, CRNA

• Student in an Organized Health Care Education/Training Program in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.