Individual provider Active NPI

Eric Canonaco, DPT

  • Physical Therapist
  • Fair Lawn, NJ
National Provider Identifier
1003771528
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02392100 Issued in NJ
Practice address
17-17 Route 208 Ste 116
Fair Lawn, NJ 07410-2819
Phone
(201) 291-0750
Fax
(201) 291-0753
NPI assigned
Dec 17, 2025
Last updated
Dec 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA02392100 NJ Primary

Addresses

Primary practice location

17-17 Route 208 Ste 116
Fair Lawn, NJ 07410-2819

Mailing address

17-17 Route 208 Ste 116
Fair Lawn, NJ 07410-2819
Phone (201) 291-0750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251230000829 NJ Practitioner - Physical Therapist in Private Practice 3678069614 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sportscare of America, PCGroup PAC ID 9032213756, 132 clinicians
United Sports Care and Physical TherapyGroup PAC ID 9436324886, 41 clinicians

Practice addresses (Care Compare)

11 Eagle Rock Ave
Suite 201
East Hanover, NJ 07936-3167
Phone (973) 887-0115

17-17 Route 208
Suite 116
Fair Lawn, NJ 07410-2819
Phone (201) 291-0750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02392100NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sportscare of America, PC Physical Therapist CurrentSince Dec 17, 2025 Accepting new patients
United Sports Care & Physical Therapy Physical Therapist CurrentSince Dec 17, 2025 Accepting new patients
Sportscare Institute, Inc. Physical Therapist Past Accepting new patients

Locations

47 S Washington Ave
Bergenfield, NJ 07621
Phone (201) 384-2525

1161 Burnt Tavern Rd
Brick, NJ 08724
Phone (732) 458-1255

197 Ridgedale Ave
Cedar Knolls, NJ 07927
Phone (973) 292-0700

11 Eagle Rock Ave
Ste 201
East Hanover, NJ 07936

17-17 Route 208
Ste 116
Fair Lawn, NJ 07410
Phone (201) 291-0750

80 Oak Hill Rd
Red Bank, NJ 07701
Phone (732) 741-2313

111 W Water St
Toms River, NJ 08753
Phone (732) 473-9440

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1765929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1003771528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17-17 ROUTE 208 STE 116",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102819",
            "telephone_number": "201-291-0750",
            "fax_number": "201-291-0753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17-17 ROUTE 208 STE 116",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102819",
            "telephone_number": "201-291-0750",
            "fax_number": "201-291-0753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANONACO",
        "first_name": "ERIC",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-17",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02392100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.