Individual provider Active NPI

Kristi L Canzano, PA-C

  • Physician Assistant
  • Twinsburg, OH
National Provider Identifier
1003879388
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50000838 Issued in OH
Practice address
1999 Enterprise Pkwy
Twinsburg, OH 44087-2207
Phone
(330) 963-5206
NPI assigned
Apr 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50000838 OH Primary

Addresses

Primary practice location

1999 Enterprise Pkwy
Twinsburg, OH 44087-2207

Mailing address

7572 Deer Path
Brecksville, OH 44141-2880
Phone (440) 832-0618

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070628000109 OH Practitioner - Physician Assistant 1557460763 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Jul 22, 2015 Accepting new patients
Emergency Care Specialists Inc Past Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

12300 McCracken Rd
Garfield Hts, OH 44125
Phone (216) 581-0500

Organizations & group practices 2

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": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427932800000",
    "number": "1003879388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7572 DEER PATH",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441412880",
            "telephone_number": "440-832-0618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1999 ENTERPRISE PKWY",
            "city": "TWINSBURG",
            "state": "OH",
            "postal_code": "440872207",
            "telephone_number": "330-963-5206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANZANO",
        "first_name": "KRISTI",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-08",
        "last_updated": "2015-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50000838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twinsburg, OH

Sources for this page

Verify at the official NPI Registry.