Individual provider Active NPI

Ines Jacqueline Cangana

  • Medical Physician Assistant
  • New York, NY
National Provider Identifier
1083774392
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
010991 Issued in NY
Practice address
462 1St Ave
New York, NY 10016-9196
Phone
(212) 562-2355
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 010991 NY Primary

Addresses

Primary practice location

462 1St Ave
New York, NY 10016-9196

Mailing address

36 Dekalb Ave
White Plains, NY 10605-1427
Phone (914) 681-1857

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20200122000110 NY Order and Referring Only - Physician Assistant 8123453107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010991NYMDMental Health Counselor

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: icangana673504@nychhc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083774392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 DEKALB AVE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106051427",
            "telephone_number": "914-681-1857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169196",
            "telephone_number": "212-562-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANGANA",
        "first_name": "INES",
        "middle_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "010991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.