Elmo Canillas, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MA05712700 Issued in NJ

Practice address

55 Meadowlands Parkway
Secaucas, NJ 07094

Phone

(201) 819-2099

NPI assigned

Dec 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stellar Anesthesia Associates LLCGroup PAC ID 4688938285, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Stellar Anesthesia Associates LLC

  • Anesthesiology Physician
  • Bergenfield, NJ
  • NPI 1265948517

  Anesthesiology, NJ

  Medicare reassignment Care Compare group NPD
• Canj Anesthesia LLC

  • Anesthesiology Physician
  • Secaucus, NJ
  • NPI 1881353662

  Anesthesiology, NJ

  Medicare reassignment NPD
• New Jersey Anesthesia Services LLC

  • Anesthesiology Physician
  • Cranford, NJ
  • NPI 1689337826

  Anesthesiology, NJ

  Medicare reassignment NPD
• North American Partners in Anesthesia of New Jersey LLC

  • Anesthesiology Physician
  • Brick, NJ
  • NPI 1548433048

  Anesthesiology

  NPD
• Meadowlands Anesthesia Associates

  • Specialist
  • Ridgefield, NJ
  • NPI 1528156494
  NPD (past)
• Michele Lewis M.D. P.a.

  • Anesthesiology Physician
  • Secaucus, NJ
  • NPI 1427202464

  Anesthesiology

  NPD (past)

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429056000000",
    "number": "1073677555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3998 FAIR RIDGE DR",
            "address_2": "SUITE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332921",
            "telephone_number": "703-295-9360",
            "fax_number": "703-295-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MEADOWLANDS PARKWAY",
            "city": "SECAUCAS",
            "state": "NJ",
            "postal_code": "07094",
            "telephone_number": "201-819-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANILLAS",
        "first_name": "ELMO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2015-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA05712700",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA05712700",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5102502",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01281145",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.