Sophina Manheimer Calderon, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

49674 Issued in AZ

Practice address

167 N Main St
Tuba City, AZ 86045-0600

Phone

(928) 283-2501

Fax

(928) 283-2677

NPI assigned

Apr 4, 2011

Last updated

Oct 13, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Rochester School of Medicine and Dentistry, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Keweenaw Bay Indian CommunityGroup PAC ID 7315070471, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baraga County Memorial Hospital Hospital, L' Anse, MI, CCN 231307
• Up Health System Portage Hospital, Hancock, MI, CCN 230108

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Tuba City Regional Health Care Corporation

  dba Tuba City Indian Medical Center

  • General Acute Care Hospital
  • Tuba City, AZ
  • NPI 1548294424

  Family Medicine, TX

  Medicare reassignment NPD
• Keweenaw Bay Indian Community

  • Federally Qualified Health Center (FQHC)
  • Baraga, MI
  • NPI 1336232289
  Care Compare group NPD (past)
• Tuba City Regional Health Care Corporation

  dba Bodaway Gap Clinic

  • Family Medicine Physician
  • Bodaway Gap, AZ
  • NPI 1710519913
  NPD
• Keweenaw Bay Indian Community D.a.Lapointe Health Facility Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Baraga, MI
  • NPI 1114217833
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baraga County Memorial Hospital

  • Critical Access Hospital
  • L'Anse, MI
  • NPI 1558479824
  Care Compare affiliation
• Portage Hospital LLC

  dba UP Health System Portage

  • General Acute Care Hospital
  • Hancock, MI
  • NPI 1245667229
  Care Compare affiliation

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1861781593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600",
            "city": "TUBA CITY",
            "state": "AZ",
            "postal_code": "860450600",
            "telephone_number": "928-283-2501",
            "fax_number": "928-283-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 N MAIN ST",
            "city": "TUBA CITY",
            "state": "AZ",
            "postal_code": "860450600",
            "telephone_number": "928-283-2501",
            "fax_number": "928-283-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERON",
        "first_name": "SOPHINA",
        "middle_name": "MANHEIMER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-04",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "49674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Bancroft Burrage, M.D. M.P.H.
• Katherine Bussard, CNM
• Blanche Rose Butler, CNA
• Lyghton Butler, CNA
• Mary C Byrne, PHARM.D, BCPS
• Karen Marie Camp, RN
• John Grady Campbell, R.T.
• Hazel Ibarra Camungao, R.N.
• Lela Dagmar Cantualla
• Linda A Capdeboscq, NP

• Family Medicine Physician in Tuba City, AZ
• Providers in Tuba City, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2014; 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.