Individual provider Active NPI

Roberto Caneva

  • Podiatrist
  • Joliet, IL
National Provider Identifier
1003444266
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
135.001092 Issued in IL
Practice address
200 N Hammes Ave
Joliet, IL 60435-6677
Phone
(815) 741-0791
NPI assigned
Mar 31, 2020
Last updated
Sep 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Podiatrist 213E00000X 135.001092 IL Primary

Addresses

Primary practice location

200 N Hammes Ave
Joliet, IL 60435-6677

Mailing address

200 N Hammes Ave
Joliet, IL 60435-6677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240129002898 IL Practitioner - Podiatry 7517310352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
R Franklin University of Med & Sci/Chicago Medical School, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caneva Foot and Ankle Clinic, LTD.Group PAC ID 8921133018, 4 clinicians

Practice addresses (Care Compare)

200 N Hammes Ave
Joliet, IL 60435-6677
Phone (815) 741-0791

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue132
Removal of skin lesions17
Removal of nail tissue778
Removal or shaving of skin growth361

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
135.001092ILMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Caneva Foot & Ankle Clinic, LTD. Podiatrist CurrentSince Jan 11, 2024 Accepting new patients

Locations

200 N Hammes Ave
Joliet, IL 60435
Phone (815) 741-0791

1000 S Hamilton St
Lockport, IL 60441
Phone (815) 838-4921

Networks

  • IL PPO Downstate
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • IL HMO C-SNP
  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/Cjes5HkVls0-AOSEdGoBEur2OUfYZvUw/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1003444266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N HAMMES AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N HAMMES AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356677",
            "telephone_number": "815-741-0791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANEVA",
        "first_name": "ROBERTO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-31",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "135.001092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.