Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dexter Mata Caldona

Individual provider Nurse Practitioner · NPI 1114415155

Dexter Mata Caldona is a Nurse Practitioner in Passaic, New Jersey. Qualified in 2016, 10 years ago. Practices with Kane Wound Care LLC, a 55-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
10
Licensed in
NJ
In the registry since
2018
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Practice location Address checks out

39 Aycrigg Ave
Passaic, NJ 07055-5664
Phone: (973) 981-0476
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 26NJ00636200 (NJ)

Record details

NPI number1114415155
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 25, 2018
Last updated in NPPESApril 25, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Kane Wound Care Llc — 55 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Passaic