Andrew Gene Caldieraro, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019.028821 Issued in IL

Practice address

1011 Charleston Ave E
Mattoon, IL 61938-6226

Phone

(217) 235-5900

NPI assigned

Sep 16, 2011

Last updated

Sep 16, 2011By the provider in NPPES

Sex

Male

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 IL, MO2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aria Dental Care PC

  • Dentist
  • Overland Park, KS
  • NPI 1942977632

  IL, MO

  Medicare reassignment NPD

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

{
    "created_epoch": "1316131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316131200000",
    "number": "1619259470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 CHARLESTON AVE E",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619386226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 CHARLESTON AVE E",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619386226",
            "telephone_number": "217-235-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDIERARO",
        "first_name": "ANDREW",
        "middle_name": "GENE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-16",
        "last_updated": "2011-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.028821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daneya Burnett, RSA
• Joseph Burton, D.O.
• Kendal Ryan Butler, PA-C
• Amber Leigh Cagungun, CRNA
• Vincent P Cagungun, RN
• John Caltry, D.O.
• Domenica Camaci-Douleh
• Timothy H Camden, MD
• Quinn Easton Camfield, PA-C, RRT
• Kelli D Canada, LCSW

• Dentist in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; 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.