Individual provider Active NPI

Federico Ledda Calixtro Jr., DNP, APRN, FNP-C

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1750907952
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
831822 Issued in NV
Practice address
4275 Burnham Ave Ste 102
Las Vegas, NV 89119-5488
Phone
(503) 317-6672
NPI assigned
Jun 23, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 831822 NV Primary

Addresses

Primary practice location

4275 Burnham Ave Ste 102
Las Vegas, NV 89119-5488

Mailing address

1349 Jewelstone Cir
Henderson, NV 89012-4902
Phone (503) 317-6672

Other practice location 1

1210 S Valley View Blvd Ste 102
Las Vegas, NV 89102-1857
Phone (702) 333-1215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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

Enrollment IDStateProvider typePAC IDDetails
I20200804003384 NV Practitioner - Nurse Practitioner 0547685794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acv Nevada Bernstein PLLCGroup PAC ID 6800227646, 4 clinicians

Practice addresses (Care Compare)

4275 Burnham Ave
Suite 102
Las Vegas, NV 89119-5495
Phone (702) 878-8346

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Acv Nevada Bernstein PLLC CurrentSince Aug 1, 2020 Accepting new patients

Locations

1525 E Beltline Ave NE
Ste 101
Grand Rapids, MI 49525
Phone (616) 363-0055

4275 Burnham Ave
Ste 102
Las Vegas, NV 89119
Phone (702) 878-8346

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1750907952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1349 JEWELSTONE CIR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890124902",
            "telephone_number": "503-317-6672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4275 BURNHAM AVE STE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195488",
            "telephone_number": "503-317-6672"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1210 S Valley View Blvd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891021857",
            "country_code": "US",
            "telephone_number": "702-333-1215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALIXTRO",
        "first_name": "FEDERICO",
        "middle_name": "LEDDA",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DNP, APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "831822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.