Individual provider Active NPI

Bianca Nilani Calderon, M.D.

  • Pediatrics Physician
  • Bronx, NY
National Provider Identifier
1780003855
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
281985 Issued in NY
Practice address
1110 Boston Rd
Bronx, NY 10456
Phone
(718) 860-2515
Fax
(718) 860-2519
NPI assigned
Apr 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 281985 NY Primary

Addresses

Primary practice location

1110 Boston Rd
Bronx, NY 10456

Mailing address

1110 Boston Rd
Bronx, NY 10456-5375
Phone (718) 860-2515

Other identifiers 2

IdentifierTypeStateIssuer
281985OtherNYMEDICAL LICENSE
04797655MedicaidNY

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170824000492 NY Practitioner - Pediatric Medicine 7618249772 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
281985NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Pediatrics CurrentSince Jun 23, 2017 Accepting new patients
Montefiore Medical Center CurrentSince Jun 23, 2017 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

305 E 161st St
Bronx, NY 10451
Phone (718) 410-4711

1110 Boston Rd
Bronx, NY 10456
Phone (718) 860-2515

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: bcaldero@montefioredirect.com

Organizations & group practices 2

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": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1780003855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 BOSTON RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104565375",
            "telephone_number": "718-860-2515",
            "fax_number": "718-860-2519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 BOSTON RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10456",
            "telephone_number": "718-860-2515",
            "fax_number": "718-860-2519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERON",
        "first_name": "BIANCA",
        "middle_name": "NILANI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "281985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "281985",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04797655",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.