Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

DR. SERGIO NICOLAS PAEZ-CALDERON MD
NPI 1174199590
Student in an Organized Health Care Education/Training Program in Indianapolis, IN

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since May 27, 2021PECOS Enrolled

550 UNIVERSITY BLVD RM 641, INDIANAPOLIS, IN 46202(317) 274-0010 Get Directions Write a Review

NPPES record last updated: July 9, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 9, 2026, May 27, 2021 (2 updates tracked since 2021).

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About Dr. Sergio Nicolas Paez-calderon Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SERGIO NICOLAS PAEZ-CALDERON MD (NPI 1174199590) is an individual student in an organized health care education/training program in Indianapolis, Indiana, licensed in Indiana (11024798A) and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174199590

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. SERGIO NICOLAS PAEZ-CALDERONCredential: MD

Location Address550 UNIVERSITY BLVD RM 641Indianapolis, IN 46202-5149

Mailing Address550 University Blvd Rm 641Indianapolis, IN 46202-5149 · (317) 274-0010

Phone(317) 274-0010

Sole ProprietorYes

Enumeration DateMay 27, 2021

Last NPPES UpdateJuly 9, 20262 updates tracked since enumeration

NPPES CertifiedJuly 9, 2026

✔ NPI 1174199590 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in IN · 11024798A

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedRadiology · Diagnostic RadiologyTaxonomy 2085R0202X · License 289621 (MA)

550 UNIVERSITY BLVD RM 641, Indianapolis, IN 46202

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Sergio Nicolas Paez-calderon Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JUAN NICOLAS USECHE GOMEZ M.D.

Radiology (Neuroradiology)