Individual provider Active NPI

Michael R Caballero, LCSW

  • Social Worker
  • Amherst, NY
National Provider Identifier
1659441426
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
R0380391 Issued in NY
Practice address
315 Alberta Drive
Suite 211
Amherst, NY 14226
Phone
(716) 837-6705
Fax
(716) 837-6759
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X R0380391 NY Primary

Addresses

Primary practice location

315 Alberta Drive
Suite 211
Amherst, NY 14226

Mailing address

315 Alberta Drive
Suite 211
Amherst, NY 14226
Phone (716) 837-6705

Other identifiers 3

IdentifierTypeStateIssuer
6207255OtherINDEPENDENT HEALTH
000523528008OtherBLUE CROSS
00020323604OtherUNIVERA

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0380391NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659441426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 ALBERTA DRIVE",
            "address_2": "SUITE 211",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "14226",
            "telephone_number": "716-837-6705",
            "fax_number": "716-837-6759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 ALBERTA DRIVE",
            "address_2": "SUITE 211",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "14226",
            "telephone_number": "716-837-6705",
            "fax_number": "716-837-6759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABALLERO",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "R0380391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "6207255",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000523528008",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00020323604",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.