Peter Sandalio Callejo-Black

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2023-01933 Issued in NC

Practice address

1301 Fayetteville St
Durham, NC 27707-2325

Phone

(919) 956-4000

NPI assigned

Apr 2, 2020

Last updated

Aug 10, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 NC

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

Duke University School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lincoln Community Health Center IncorporatedGroup PAC ID 4587642590, 50 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pcallejoblack281576@direct.medicine.duke.edu

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.

• Lincoln Community Health Center Incorporated

  • Federally Qualified Health Center (FQHC)
  • Durham, NC
  • NPI 1114978582
  Medicare reassignment Care Compare group NPD
• Lincoln Community Health Center Incorporated

  dba Lakewood Clinic

  • Federally Qualified Health Center (FQHC)
  • Durham, NC
  • NPI 1114614518
  NPD

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1871122887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 MYRA WAY",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941271715",
            "telephone_number": "415-533-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 FAYETTEVILLE ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072325",
            "telephone_number": "919-956-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLEJO-BLACK",
        "first_name": "PETER",
        "middle_name": "SANDALIO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-02",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2023-01933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert M Califf, M.D.
• Laura Caligiuri
• Kevin Holden Calkins, MPT
• Kerry Frances Callahan-Mandulak, MA, CCC-SLP
• Marley Rita Callahan
• Patricia Callison, DPT
• Calm Carolina Counseling, PLLC
• Calming Counseling PLLC
• Sara Bristol Calvert, PHARM.D.
• Sarah Frances Calvert, FNP

• Family Medicine Physician in Durham, NC
• Providers in Durham, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.