Mark Cannizzaro, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301012725 Issued in MI

Practice address

120 N Washington SQ Ste 300
Lansing, MI 48933-1658

Phone

(734) 210-1854

Fax

(517) 627-1289

NPI assigned

Jan 18, 2007

Last updated

Mar 13, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1144373812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N WASHINGTON SQ STE 300",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489331658",
            "telephone_number": "734-210-1854",
            "fax_number": "517-627-1289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N WASHINGTON SQ STE 300",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489331658",
            "telephone_number": "734-210-1854",
            "fax_number": "517-627-1289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNIZZARO",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301012725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas J Campbell, DO
• Sandra Angela Campbell, PHARM D
• Rachelle Campeau-Pappas
• Kenzie Cannarile, BS
• Peter John Cannella Jr.
• T'Shara Cannon, MA, LLPC
• Samantha Cantrell
• Jesus Cantu
• Heather Maria Cantwell
• Cap-Lab PLC

• Psychologist in Lansing, MI
• Providers in Lansing, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; 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.