Individual provider Active NPI

Dawn Cannon, P.A.-C

  • Surgical Physician Assistant
  • New York, NY
National Provider Identifier
1043477870
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
003116 Issued in NY
Practice address
535 E 70TH St
New York, NY 10021-4872
Phone
(212) 606-1684
NPI assigned
May 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 003116 NY Primary

Addresses

Primary practice location

535 E 70TH St
New York, NY 10021-4872

Mailing address

535 E 70TH St
New York, NY 10021-4872
Phone (212) 606-1684

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20210712002662 NJ Practitioner - Physician Assistant 4284827304 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
003116NYMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince May 24, 2021 Accepting new patients
Barnabas Health Medical Group PC CurrentSince May 24, 2021 Accepting new patients

Locations

95 Greene St
Jersey City, NJ 07302
Phone (201) 499-8730

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

3 Executive Dr
Ste 400
Somerset, NJ 08873
Phone (732) 369-5949

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": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1043477870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 E 70TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214872",
            "telephone_number": "212-606-1684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 E 70TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214872",
            "telephone_number": "212-606-1684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "DAWN",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "003116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.