Individual provider Active NPI

Linda Cristina Calderon, PSYD

  • Clinical Neuropsychologist
  • New York, NY
National Provider Identifier
1750860144
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
022760 Issued in NY
Practice address
635 W 165TH St RM 633a
New York, NY 10032-3724
Phone
(646) 317-2248
NPI assigned
Aug 7, 2018
Last updated
Aug 7, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 022760 NY Primary
Clinical Child & Adolescent Psychologist 103TC2200X 022760 NY

Addresses

Primary practice location

635 W 165TH St RM 633a
New York, NY 10032-3724

Mailing address

635 W 165TH St RM 633a
New York, NY 10032-3724
Phone (646) 317-2248

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221229002652 NY Practitioner - Clinical Psychologist 7113262262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Nova Southeastern Univ College of Dental Medicine, 2016
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
East Rockaway Neuropsychology, PCGroup PAC ID 0547509739, 16 clinicians

Practice addresses (Care Compare)

100 Merrick Rd
Rockville Centre, NY 11570-4800
Phone (516) 341-6215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
022760NYMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
East Rockaway Neuropsychology, PC Clinical Neuropsychologist CurrentSince Dec 1, 2022 Accepting new patients

Locations

100 Merrick Rd
Ofc 510E
Rockville Ctr, NY 11570

100 Merrick Rd
Ste 510
Rockville Ctr, NY 11570
Phone (516) 341-6215

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1750860144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 W 165TH ST RM 633A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323724",
            "telephone_number": "646-317-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 W 165TH ST RM 633A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323724",
            "telephone_number": "646-317-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERON",
        "first_name": "LINDA",
        "middle_name": "CRISTINA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "022760",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "022760",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.