Individual provider Active NPI

Edith Calderon, M.D.

  • Pediatrics Physician
  • Carolina, PR
National Provider Identifier
1952384257
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
10305 Issued in PR
Practice address
State Road 3 KM 8.3 , 65TH Infanteria Ave.
Carolina, PR 00984
Phone
(787) 757-1800
NPI assigned
Nov 22, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 10305 PR Primary

Addresses

Primary practice location

State Road 3 KM 8.3 , 65TH Infanteria Ave.
Carolina, PR 00984

Mailing address

Cond Monte Real
Buzon 123
San Juan, PR 00926-8211
Phone (787) 748-3504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20160629002230 PR Practitioner - Pediatric Medicine 4981996576 Practice locations: Rio Grande, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10305PRMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Servicios Medicos Universitarios Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: uprech@yourcarecommunity.org

Organizations & group practices 1

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952384257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COND MONTE REAL",
            "address_2": "BUZON 123",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009268211",
            "telephone_number": "787-748-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STATE ROAD 3 KM 8.3 , 65TH INFANTERIA AVE.",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00984",
            "telephone_number": "787-757-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERON",
        "first_name": "EDITH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "10305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.