Tiana Carrillo Calderon, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-143425 Issued in IL

Practice address

133 E Brush Hill Rd Ste 205
Elmhurst, IL 60126-5659

Phone

(331) 221-5701

Fax

(331) 221-3893

NPI assigned

May 8, 2014

Last updated

Feb 19, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Tiana Carrillo Calderon Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Family Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elmhurst Memorial Hospital Hospital, Elmhurst, IL, CCN 140200
• Edward Hospital Hospital, Naperville, IL, CCN 140231

Merit-based Incentive Payment System (MIPS)

Final score

84.9 of 100Reported as group

Quality

75.91

Promoting interoperability

99

Improvement activities

40

Cost

74.6

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tcarrillocalderon171799@direct.edward.org

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.

• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Allergy & Immunology Physician
  • Evanston, IL
  • NPI 1497701882

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Edward Health Ventures

  • Multi-Specialty Clinic/Center
  • Bolingbrook, IL
  • NPI 1962452912

  Single Specialty

  Medicare reassignment NPD
• Edward Health Ventures

  • Family Medicine Physician
  • Oswego, IL
  • NPI 1255501029
  NPD
• Endeavor Health Medical Group

  dba NorthShore Anesthesia Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944

  Single Specialty

  NPD
• Edward Health Ventures

  dba Edward Medical Group

  • Internal Medicine Physician
  • Naperville, IL
  • NPI 1790735744

  Single Specialty

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Edward Hospital

  dba Endeavor Health Edward Hospital

  • General Acute Care Hospital
  • Naperville, IL
  • NPI 1427069632
  Care Compare affiliation
• Elmhurst Memorial Hospital

  dba Endeavor Health Elmhurst Hospital

  • General Acute Care Hospital
  • Elmhurst, IL
  • NPI 1548306343
  Care Compare affiliation

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

{
    "created_epoch": "1399507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1619388923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 E BRUSH HILL RD STE 205",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265659",
            "telephone_number": "331-221-5701",
            "fax_number": "331-221-3893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 E BRUSH HILL RD STE 205",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265659",
            "telephone_number": "331-221-5701",
            "fax_number": "331-221-3893"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "836 W Wellington Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606575147",
            "country_code": "US",
            "telephone_number": "773-975-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRILLO CALDERON",
        "first_name": "TIANA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-08",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-143425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tcarrillocalderon171799@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "133 E Brush Hill Rd Ste 205",
            "city": "Elmhurst",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601265659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TIANA",
            "last_name": "CARRILLO CALDERON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Juanito Camara Capuno Jr., PT
• Care Medical Supplies Inc (Rotech of Elmhurst)
• Caremed Solutions LLC
• Kurt K Carlson, DMD
• Osvaldo Carnalla Jr.
• Samantha Carteno
• Susan A Carter, M.S., OTR/L
• Madison Cartier
• Mar Carvajal
• Caroline A Casey, M.D.

• Family Medicine Physician in Elmhurst, IL
• Providers in Elmhurst, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.