Individual provider Active NPI

Daniel Anthony Calabrese, MD

  • Neonatal-Perinatal Medicine Physician
  • San Luis, AZ
National Provider Identifier
1881889103
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
37902 Issued in AZ
Practice address
1896 E. Babbit Lane
San Luis, AZ 85349-1669
Phone
(928) 722-6112
Fax
(928) 722-6113
NPI assigned
Sep 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 37902 AZ Primary

Addresses

Primary practice location

1896 E. Babbit Lane
San Luis, AZ 85349-1669

Mailing address

PO Box 617
Somerton, AZ 85350-0617
Phone (928) 662-0406

Other identifiers 2

IdentifierTypeStateIssuer
324722MedicaidAZ
Z156217OtherAZMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20130307000526 AZ Practitioner - Pediatric Medicine 9537119417 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37902AZMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Luis Walk-in Clinic, Inc. Current Accepting new patients
San Luis Walk-in Clinic, Inc. CurrentSince Dec 10, 2012 Accepting new patients
San Luis Walk-in Clinic, Inc. CurrentSince Dec 10, 2012 Accepting new patients

Locations

214 W Main St
Somerton, AZ 85350
Phone (928) 627-1120

950 E Main St
Bldg C
Somerton, AZ 85350
Phone (928) 324-1040

950 E Main St
Bldg B
Somerton, AZ 85350
Phone (928) 236-8001

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11823/brand/2/csg/41/fhir/r4

Organizations & group practices 3

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": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1881889103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 617",
            "city": "SOMERTON",
            "state": "AZ",
            "postal_code": "853500617",
            "telephone_number": "928-662-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1896 E. BABBIT LANE",
            "city": "SAN LUIS",
            "state": "AZ",
            "postal_code": "853491669",
            "telephone_number": "928-722-6112",
            "fax_number": "928-722-6113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALABRESE",
        "first_name": "DANIEL",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-10",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "AZ",
            "license": "37902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "324722",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Z156217",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis, AZ

Sources for this page

Verify at the official NPI Registry.