Edye A Calderon, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1645 Issued in OK

Practice address

319 E Josephine
Frederick, OK 73542

Phone

(580) 335-7545

Fax

(580) 335-7619

NPI assigned

Sep 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

85.33 of 100Reported as group

Quality

74.13

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/856/brand/1/csg/1/fhir/r4

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.

• Basin Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Odessa, TX
  • NPI 1831337724

  TX

  Medicare reassignment
• Cardiothoracic and Vascular Surgeons,PA

  • Surgery Physician
  • Austin, TX
  • NPI 1326061714
  NPD (past)
• Carondelet Health Network

  • Psychiatric Hospital Unit
  • Tucson, AZ
  • NPI 1750788667
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218585600000",
    "number": "1669577474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 785",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "73502",
            "telephone_number": "580-357-9984",
            "fax_number": "580-357-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 E JOSEPHINE",
            "city": "FREDERICK",
            "state": "OK",
            "postal_code": "73542",
            "telephone_number": "580-335-7545",
            "fax_number": "580-335-7619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERON",
        "first_name": "EDYE",
        "middle_name": "A",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2008-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "2868",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "2868",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "242722104",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "816176",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200116340A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Douglas Ade, P.T., A.T.C.
• Clay Wesley Anderson, D.D.S.
• B & a Medical Supply
• Stephanie Alisha Batt, PA
• Connie Bookout
• Bernette Calvin
• Paul D Carpenter, D. PH.
• Jesse Kaydon Cheek
• Kendell Elaine Clark, MS, LPC, NCC
• Cole Bros. Inc.

• All providers in Frederick, OK
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; 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.