Individual provider Active NPI

Jeannine Castaneda Calderon, PA-C

  • Medical Physician Assistant
  • Clermont, FL
National Provider Identifier
1922609114
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9113816 Issued in FL
Practice address
16966 Cagan Ridge Blvd Ste 220
Clermont, FL 34714-9656
Phone
(321) 843-5851
Fax
(321) 843-1673
NPI assigned
Nov 4, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9113816 FL
Medical Physician Assistant 363AM0700X PA9113816 FL Primary

Addresses

Primary practice location

16966 Cagan Ridge Blvd Ste 220
Clermont, FL 34714-9656

Mailing address

16966 Cagan Ridge Blvd Ste 220
Clermont, FL 34714-9656
Phone (321) 843-5851

Other practice location 1

30115 State Road 52 Ste 101
San Antonio, FL 33576-8243
Phone (813) 467-4244

Other practice location 2

22425 Oakville Dr
Land O Lakes, FL 34639-3938
Phone (630) 677-5709

Other practice location 3

6748 Gall Blvd
Zephyrhills, FL 33542-2511
Phone (813) 467-4270

Other identifiers 1

IdentifierTypeStateIssuer
113752000MedicaidFL

Other names 1

  • Jeannine C Calderon Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220404002476 FL Practitioner - Physician Assistant 2961898770 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

1285 Orange Ave
Winter Park, FL 32789-4984
Phone (407) 647-2287

16966 Cagan Ridge Blvd
Clermont, FL 34714-9656

22 W Underwood St
Orlando, FL 32806-1110
Phone (407) 648-3800

2700 Healing Way
Wesley Chapel, FL 33543-5453

32 W Gore St
Orlando, FL 32806-1134

5151 Winter Garden Vineland Rd
Windermere, FL 34786-6098

52 W Underwood St
Orlando, FL 32806-1110
Phone (407) 841-5111

60 Columbia St
Orlando, FL 32806-1115
Phone (321) 843-5851

62 Columbia St
Orlando, FL 32806-1115
Phone (321) 843-5851

76 W Underwood St
Orlando, FL 32806-1110

86 W Underwood St
Orlando, FL 32806-1110
Phone (407) 896-1100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9113816FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Aug 18, 2025 Accepting new patients
Boland & Mannari LLC PastSince Mar 1, 2021 Accepting new patients
Florida Hospital Zephyrhills Inc PastSince Feb 1, 2022 Accepting new patients

Locations

16966 Cagan Ridge Blvd
Ste 220
Clermont, FL 34714
Phone (407) 347-2979

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1922609114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16966 CAGAN RIDGE BLVD STE 220",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347149656",
            "telephone_number": "321-843-5851",
            "fax_number": "321-843-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16966 CAGAN RIDGE BLVD STE 220",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347149656",
            "telephone_number": "321-843-5851",
            "fax_number": "321-843-1673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30115 State Road 52 Ste 101",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "FL",
            "postal_code": "335768243",
            "country_code": "US",
            "telephone_number": "813-467-4244",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22425 Oakville Dr",
            "address_purpose": "LOCATION",
            "city": "Land O Lakes",
            "state": "FL",
            "postal_code": "346393938",
            "country_code": "US",
            "telephone_number": "630-677-5709",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6748 Gall Blvd",
            "address_purpose": "LOCATION",
            "city": "Zephyrhills",
            "state": "FL",
            "postal_code": "335422511",
            "country_code": "US",
            "telephone_number": "813-467-4270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASTANEDA CALDERON",
        "first_name": "JEANNINE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-04",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113816",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9113816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113752000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANNINE",
            "last_name": "CALDERON",
            "middle_name": "C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.