Individual provider Active NPI

David J Calixte, PHARMD, RPH

  • Pharmacist
  • Worcester, MA
National Provider Identifier
1619385267
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH235293 Issued in MA
Practice address
25 Tobias Boland Way
Worcester, MA 01607-2103
Phone
(774) 314-3162
NPI assigned
Jul 28, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH235293 MA Primary

Addresses

Primary practice location

25 Tobias Boland Way
Worcester, MA 01607-2103

Mailing address

78 West St
Randolph, MA 02368-4020
Phone (617) 201-2289

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PH235293MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East LP Past Accepting new patients
Wal-Mart Stores East, LP Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1619385267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 WEST ST",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684020",
            "telephone_number": "617-201-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 TOBIAS BOLAND WAY",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016072103",
            "telephone_number": "774-314-3162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALIXTE",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "PHARMD, RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-28",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH235293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.